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Original Articles

Physical therapy

Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya Oku, Junji Hatakeyama, Keibun Liu, Kentaro Tojo, Masafumi Idei, Shigeaki Inoue, Kazuma Yamakawa, Takeshi Nishida, Shinichiro Ohshimo, Satoru Hashimoto, Shuhei Maruyama, Yoshitaka Ogata, Daisuke Kawakami, Hiroaki Shimizu, Katsura Hayakawa, Yuji Fujino, Taku Oshima, Tatsuya Fuchigami, Hironori Yawata, Kyoji Oe, Akira Kawauchi, Hidehiro Yamagata, Masahiro Harada, Yuichi Sato, Tomoyuki Nakamura, Kei Sugiki, Takahiro Hakozaki, Satoru Beppu, Masaki Anraku, Noboru Kato, Tomomi Iwashita, Hiroshi Kamijo, Yuichiro Kitagawa, Michio Nagashima, Hirona Nishimaki, Kentaro Tokuda, Osamu Nishida, Kensuke Nakamura
Ann Rehabil Med 2025;49(1):49-59.   Published online February 28, 2025
DOI: https://doi.org/10.5535/arm.240066
Objective
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.
  • 4,829 View
  • 71 Download

Cardiopulmonary rehabilitation

Effect of Pre- and Post-Dialysis Exercise on Functional Capacity Using Portable Ergometer in Chronic Kidney Disease Patients
Tae-Seok Chae, Da-Sol Kim, Myoung-Hwan Ko, Yu Hui Won
Ann Rehabil Med 2024;48(4):239-248.   Published online August 30, 2024
DOI: https://doi.org/10.5535/arm.240005
Objective
To assess whether performing exercises during hemodialysis reduces the risk of developing intradialytic hypotension and enhances exercise capacity in patients with chronic kidney disease.
Methods
This study included patients aged ≥18 years undergoing hemodialysis. Participants performed exercises using a portable lower extremity ergometer during hemodialysis sessions for 3 weeks. Data regarding walking distance, knee strength, quality of life, fat-free mass, arterial pressure, blood pressure, heart rate, frequency of intradialytic hypotension, fatigue, and duration of hemodialysis were collected and analyzed.
Results
Significant improvements in walking distance and knee strength were observed following the implementation of exercise training during hemodialysis. Although there was no significant reduction in the frequency of intradialytic hypotension, a decreasing trend was noted. Other parameters such as quality of life and fatigue did not show significant changes.
Conclusion
Using a portable ergometer during hemodialysis improved exercise capacity and knee strength in patients with chronic kidney disease. There was a trend toward reduced intradialytic hypotension, suggesting potential cardiovascular benefits. Further research with larger sample sizes is needed to confirm these findings.

Citations

Citations to this article as recorded by  
  • Can exercise reduce fatigue in people living with kidney disease?
    Thomas J. Wilkinson, Lisa Ancliffe, Jamie H. Macdonald
    Current Opinion in Clinical Nutrition & Metabolic Care.2025; 28(3): 200.     CrossRef
  • Effect of intra-dialytic exercise on hemodialysis session adequacy and solutes clearance and rebound in prevalent hemodialysis patients
    Howaida Elshinnawy, Hisham Elsayed, Hayam Hebah, Waleed Abdelmohsen, Dina Farrag, Mostafa Abdelnasier
    Egyptian Rheumatology and Rehabilitation.2025;[Epub]     CrossRef
  • 6,844 View
  • 137 Download
  • 2 Web of Science
  • 2 Crossref

others

Association Between Mobilization Level And Activity of Daily Living Independence in Critically Ill Patients
Shinichi Watanabe, Keibun Liu, Ryo Kozu, Daisetsu Yasumura, Kota Yamauchi, Hajime Katsukawa, Keisuke Suzuki, Takayasu Koike, Yasunari Morita
Ann Rehabil Med 2023;47(6):519-527.   Published online November 22, 2023
DOI: https://doi.org/10.5535/arm.23056
Objective
To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70.
Methods
This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL.
Results
Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07–1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69).
Conclusion
These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.

Citations

Citations to this article as recorded by  
  • Health-Related Quality of Life and Mobility Levels in ICU Survivors with Heel Pressure Ulcer: An Observational Study
    Filippo Binda, Federica Marelli, Veronica Rossi, Lucia Villa, Andrea Cislaghi, Giacomo Grasselli
    Nursing Reports.2026; 16(1): 30.     CrossRef
  • Impact of Preexisting Diabetes on Activities of Daily Living Independence at Hospital Discharge in Critically Ill Patients: A Prospective Cohort Study
    Shinichi Watanabe, Kota Yamauchi, Yuji Naito, Ayato Shinohara, Yasunari Morita, Yuki Iida
    Diabetology.2026; 7(2): 27.     CrossRef
  • Factors associated with functional recovery after intensive care unit discharge in patients with mechanical ventilation: A multi-centre prospective observational study
    Kota Yamauchi, Shinichi Watanabe, Yuji Naito, Kei Goto, Shota Tanaka, Tokuaki Shinya, Yoshihisa Fujino, Kazuki Ogawa, Tomohiro Yoshikawa, Yoshie Hirota
    Clinical Rehabilitation.2025; 39(7): 945.     CrossRef
  • Impact of Early Rehabilitation Initiation on Walking Recovery in Critically Ill Patients
    Ryuji Yoshinaga, Narumi Yamada, Ryo Kozu
    Cureus.2025;[Epub]     CrossRef
  • Balancing Rehabilitation Dose in Acute Stroke Decision-Making and Global Assessment (The BRIDGE Study)
    Shinichi Watanabe, Wataru Yamauchi, Katsuma Shoka, Asahi Kawashima, Shogo Sawamura, Kousuke Kanamori, Tetsuya Furukawa, Yuji Naito, Naoki Takeshita, Keita Utiyama, Rtota Imai, Kanari Kiritani, Naoyuki Hashimoto, Hideaki Tanaka, Yushi Mitani, Takayuki Kita
    Journal of Clinical Medicine.2025; 14(19): 6786.     CrossRef
  • Factors associated with functional independence at hospital discharge and 6 months post-hospitalization in intensive care unit survivors with cancer: A prospective cohort study
    Gustavo Telles da Silva, Lavinia Gomes Cavalcante, Maria Luiza Valério Dalzini, Leda Tomiko Yamada da Silveira, Débora Stripari Schujmann, Carolina Fu
    Supportive Care in Cancer.2025;[Epub]     CrossRef
  • Association between changes in disease severity and physical function after surviving a critical illness: A multicentre retrospective observational study
    Keibun Liu, Tomohiro Hamagami, Naoki Sugiyasu, Kenji Fujizuka, Akira Kawauchi, Sou Yamada, Takayuki Ogura, Naoko Hirata, Takafumi Tani, Shunsuke Taito, Kohei Ota, David McWilliams, Hajime Katsukawa, Toru Kotani
    Australian Critical Care.2024; 37(6): 889.     CrossRef
  • 7,396 View
  • 142 Download
  • 5 Web of Science
  • 7 Crossref

Review Article

Pediatric rehabilitation

Early Neurodevelopmental Assessments of Neonates Discharged From the Neonatal Intensive Care Unit: A Physiatrist’s Perspective
Sung Eun Hyun, Jeong-Yi Kwon, Bo Young Hong, Jin A Yoon, Ja Young Choi, Jiyeon Hong, Seong-Eun Koh, Eun Jae Ko, Seung Ki Kim, Min-Keun Song, Sook-Hee Yi, AhRa Cho, Bum Sun Kwon
Ann Rehabil Med 2023;47(3):147-161.   Published online June 27, 2023
DOI: https://doi.org/10.5535/arm.23038
The survival rate of children admitted in the neonatal intensive care unit (NICU) after birth is on the increase; hence, proper evaluation and care of their neurodevelopment has become an important issue. Neurodevelopmental assessments of individual domains regarding motor, language, cognition, and sensory perception are crucial in planning prompt interventions for neonates requiring immediate support and rehabilitation treatment. These assessments are essential for identifying areas of weakness and designing targeted interventions to improve future functional outcomes and the quality of lives for both the infants and their families. However, initial stratification of risk to select those who are in danger of neurodevelopmental disorders is also important in terms of cost-effectiveness. Efficient and robust functional evaluations to recognize early signs of developmental disorders will help NICU graduates receive interventions and enhance functional capabilities if needed. Several age-dependent, domain-specific neurodevelopmental assessment tools are available; therefore, this review summarizes the characteristics of these tools and aims to develop multidimensional, standardized, and regular follow-up plans for NICU graduates in Korea.

Citations

Citations to this article as recorded by  
  • Recurrent peripheral intravenous catheterization in neonates: A case series
    Stephanie Hall, Emily Larsen, Linda Cobbald, Nicole Marsh, Linda McLaughlin, Mari Takashima, Robert S. Ware, Amanda Ulman, Deanne August
    Nursing in Critical Care.2025;[Epub]     CrossRef
  • Evaluating Non-Invasive Computer Vision-Based Quantification of Neonatal Movement as a Marker of Development in Preterm Infants: A Pilot Study
    Janet Pigueiras-del-Real, Lionel C. Gontard, Isabel Benavente-Fernández, Syed Taimoor Hussain, Syed Adil Hussain, Simón P. Lubián-López, Angel Ruiz-Zafra
    Healthcare.2025; 13(13): 1577.     CrossRef
  • Improvement in functional motor scores in patients with non-ambulatory spinal muscle atrophy during Nusinersen treatment in South Korea: a single center study
    Jin A. Yoon, Yuju Jeong, Jiae Lee, Dong Jun Lee, Kyung Nam Lee, Yong Beom Shin
    BMC Neurology.2024;[Epub]     CrossRef
  • NICU Graduates and Psychosocial Problems in Childhood: A Systematic Review
    Ravi Gajula, Veerabadram Yeshala, Nagalakshmi Gogikar, Rakesh Kotha
    Cureus.2024;[Epub]     CrossRef
  • Performance of Activities of Daily Living in Typically Developing Children in Korea: Normative Value of K-MBI
    Mi-Jeong Yoon, Sungwoo Paek, Jongbin Lee, Youngdeok Hwang, Joon-Sung Kim, Yeun-Jie Yoo, Bo Young Hong
    Annals of Rehabilitation Medicine.2024; 48(4): 281.     CrossRef
  • Modern approaches to assessing motor development in infants and young children in clinical practice
    Natalia V. Andrushchenko, Alexander B. Palchik, Marina V. Osipova
    Russian Family Doctor.2024; 28(4): 24.     CrossRef
  • 10,525 View
  • 204 Download
  • 8 Web of Science
  • 6 Crossref

Original Articles

Cardiopulmonary rehabilitation

Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study
Shinichi Watanabe, Yuki Iida, Jun Hirasawa, Yuji Naito, Motoki Mizutani, Akihiro Uemura, Shogo Nishimura, Keisuke Suzuki, Yasunari Morita
Ann Rehabil Med 2023;47(3):173-181.   Published online June 15, 2023
DOI: https://doi.org/10.5535/arm.22153
Objective
To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU).
Methods
We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated.
Results
A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively)
Conclusion
The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.

Citations

Citations to this article as recorded by  
  • Impact of ICU-Based Extracorporeal Membrane Oxygenation and Blood Purification Therapy on the Time Required for Early Rehabilitation
    Shinichi Watanabe, Tomohiro Yoshikawa, Yoshie Hirota, Yuji Naito, Daisetsu Yasumura, Kota Yamauchi, Keisuke Suzuki, Takayasu Koike, Yasunari Morita
    Cureus.2025;[Epub]     CrossRef
  • Survival outcomes and mobilization during venovenous extracorporeal membrane oxygenation: a retrospective cohort study
    Felix A. Rottmann, Christian Noe, Xavier Bemtgen, Sven Maier, Alexander Supady, Tobias Wengenmayer, Dawid L. Staudacher
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • 5,467 View
  • 101 Download
  • 1 Web of Science
  • 2 Crossref

Spinal cord injury

Quantitative Analysis in Cervical Spinal Cord Injury Patients Using Diffusion Tensor Imaging and Tractography
Geun Seok Park, Tae Uk Kim, Seong Jae Lee, Jung Keun Hyun, Seo Young Kim
Ann Rehabil Med 2022;46(4):172-184.   Published online August 31, 2022
DOI: https://doi.org/10.5535/arm.22053
Objective
To investigate the clinical usefulness of diffusion tensor imaging (DTI) and tractography in the prediction of outcomes after traumatic cervical spinal cord injury (SCI) and to assess whether the predictability is different between DTI and tractography administered before and after surgery.
Methods
Sixty-one subjects with traumatic cervical SCI were randomly assigned to preop or postop groups and received DTI accordingly. Among the patients who had DTI before surgery, we assigned 10 patients who had received repeated DTI examinations at 8 weeks after injury to the follow-up group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained from DTI, and imaginary fiber and crossing fiber numbers were calculated from the tractography. Neurological status and functional status were assessed at 4 and 8 weeks after SCI.
Results
The neurologic and functional statuses of both groups improved after 4 weeks. Out of the initial 61 patients who were enrolled in the study, the failure rate of DTI image analysis was significantly higher in the postop group (n=17, 41.5%) than in the preop group (n=6, 20%). The FA values and fiber numbers in the preop group tended to be higher than those in the postop group, whereas ADC values were lower in the preop group. When comparing the tractographic findings in the follow-up group, imaginary fiber numbers at the C6 and C7 levels and crossing fiber numbers from the C3 to C6 levels were significantly decreased after surgery. Several DTI and tractographic parameters (especially the ADC value at the C4 level and imaginary fiber numbers at the C6 level) showed significant correlations with neurologic and functional statuses in both the preop and postop groups. These findings were most prominent when DTI and physical examination were simultaneously performed.
Conclusion
Preoperative DTI and tractography demonstrated better FA and ADC values with lower interpretation failure rates than those obtained after surgery, whereas postoperative data significantly reflected the patient’s clinical state at the time of evaluation. Therefore, DTI and tractography could be useful in predicting clinical outcomes after traumatic cervical SCI and should be interpreted separately before and after spine surgery.

Citations

Citations to this article as recorded by  
  • Diffusion tractography outside the brain: the road less travelled
    Kurt G. Schilling, Irvin Teh, Julien Cohen-Adad, Richard Dortch, Ibrahim Ibrahim, Nian Wang, Bruce Damon, Rory L. Cochran, Alexander Leemans
    Brain Structure and Function.2026;[Epub]     CrossRef
  • Negative Correlation Between Fractional Anisotropy on Diffusion Tensor Imaging and Neck Disability Index in Cervical Spondylotic Radiculopathy After Percutaneous Cervical Nucleoplasty: A Cross-Sectional Study
    Ning Fan, Tusheng Li, Xuanyu Lu, Xinyu Ma, Lihui Yang, Peng Du, Lei Zang, Shuo Yuan
    Journal of Pain Research.2025; Volume 18: 3977.     CrossRef
  • Quantitative Magnetic Resonance Identifies Recovery from Spinal Cord Injury after Bioactive Implants
    DIANA OSORIO-LONDOÑO, AXAYÁCATL MORALES-GUADARRAMA, ROBERTO OLAYO-GONZÁLEZ, ERNESTO ROLDAN-VALADEZ
    Archives of Medical Research.2024; 55(5): 103012.     CrossRef
  • 7,334 View
  • 131 Download
  • 3 Web of Science
  • 3 Crossref

Pain & Musculoskeletal rehabilitation

Association Between Length of Stay in the Intensive Care Unit and Sarcopenia Among Hemiplegic Stroke Patients
Aeri Jang, Chang Hoon Bae, Soo Jeong Han, Hasuk Bae
Ann Rehabil Med 2021;45(1):49-56.   Published online February 9, 2021
DOI: https://doi.org/10.5535/arm.20111
Objective
To discuss the association between the length of stay at the intensive care unit (ICU) and sarcopenia among hemiplegic stroke patients.
Methods
This study evaluated 66 hemiplegic stroke patients with history of ICU admission using handgrip strength and bioelectrical impedance analysis to obtain height-adjusted appendicular skeletal muscle mass. The diagnosis of sarcopenia was made according to the muscle mass based on the Asian Working Group for Sarcopenia. The patients were divided into sarcopenic and non-sarcopenic groups. The two groups were statistically analyzed, and the significant factors with differences were studied. A multivariate logistic regression analysis was performed to examine the association between length of stay in the ICU and sarcopenia, after adjusting for potential confounders.
Results
Among 66 hemiplegic patients with an ICU admission history, 12 patients were diagnosed with sarcopenia. Sarcopenia patients showed lower scores on the Korean version of the Modified Barthel Index and the Korean version of the Mini-Mental State Examination. Additionally, patients with sarcopenia had a longer length of stay in the ICU, and univariate and multivariate analyses confirmed that the ICU length of stay was significantly related to sarcopenia (adjusted odds ratio=1.187; 95% confidence interval, 1.019–1.382; p=0.028).
Conclusion
The length of stay in the ICU was significantly associated with sarcopenia in hemiplegic stroke patients.

Citations

Citations to this article as recorded by  
  • Usefulness of body composition assessment by bioelectrical impedance vector analysis in subacute post-stroke patients in rehabilitation
    Alessandro Guerrini, Mariacristina Siotto, Carola Cocco, Marco Germanotta, Valeria Cipollini, Laura Cortellini, Arianna Pavan, Stefania Lattanzi, Sabina Insalaco, Yeganeh Manon Khazrai, Irene Giovanna Aprile
    Scientific Reports.2025;[Epub]     CrossRef
  • HANDGRIP STRENGTH AND DASH EATING BEHAVIOR IS RELATED TO HIGHER BLOOD PRESSURE ON PRE-ELDERLY AND ELDERLY IN YOGYAKARTA
    Adhila Fayasari, Anis Febri Nilansari, Margala Juang Bertorio
    Media Gizi Indonesia.2025; 20(2): 135.     CrossRef
  • Effects of Leucine Supplementation in Older Adults with Sarcopenia: A Meta-Analysis
    Chienhsiu Huang, Min-Hong Hsieh
    Nutrients.2025; 17(15): 2413.     CrossRef
  • Post-Operative Atrial Fibrillation: Novel Predictive Value of CT-Derived Adipose Tissue Density in Minimally Invasive Mitral Surgery
    M Pekar, D Vician, O Jiravsky, B Jiravska Godula, P Branny, R Spacek, M Kantor, M Skotakova, J Chovancik, L Sknouril, J Novak
    Physiological Research.2025; : S117.     CrossRef
  • Indirect calorimetry directed feeding and cycling in the older ICU population: a pilot randomised controlled trial
    Ng Shu Hui Elizabeth, Tan Yanni, Leong Siaw May, Tiong Hui Fen, Li Xuanhui Janice, Kwan Peijun, Ong Sze Pheng, Toh Shi Jie, Loh Ne Hooi Will
    BMC Anesthesiology.2024;[Epub]     CrossRef
  • Effects of Brunnstrom movement therapy versus mirror therapy on hand function in post-stroke hemiplegic population
    Nimra, Ayesha Zulifiqar, Muhammad Umair Javaid, Reham Ali Mohamed Ali Ahmed
    Journal of Musculoskeletal Surgery and Research.2024; 8: 389.     CrossRef
  • Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease
    Thanapon Keawon, Narongkorn Saiphoklang
    Therapeutic Advances in Respiratory Disease.2024;[Epub]     CrossRef
  • Trunk Impairment Scale for Predicting Lumbar Spine Bone Mineral Density in Young Male Patients With Subacute Stroke
    Yeon Hee Cho, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Hyun Jung Kim
    Annals of Rehabilitation Medicine.2023; 47(2): 98.     CrossRef
  • Accuracy of Calf Circumference Measurement, SARC-F Questionnaire, and Ishii's Score for Screening Stroke-Related Sarcopenia
    Ruihong Yao, Liqing Yao, Changli Yuan, Bu-Lang Gao
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Natural aging course of lumbar extensor muscle mass and strength in community-dwelling older women: a 1-year prospective observational study
    Dong Hyun Kim, Jinhee Park, Chang Won Lee, Sang Yoon Lee
    Aging Clinical and Experimental Research.2022; 34(9): 2099.     CrossRef
  • Prognostic Value of Isolated Sarcopenia or Malnutrition–Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients
    Iasmin Matias Sousa, Camila Ferri Burgel, Flávia Moraes Silva, Ana Paula Trussardi Fayh
    Nutrients.2022; 14(11): 2207.     CrossRef
  • Effects of leucine-rich protein supplements in older adults with sarcopenia: A systematic review and meta-analysis of randomized controlled trials
    Sang Yoon Lee, Hyun Jeong Lee, Jae-Young Lim
    Archives of Gerontology and Geriatrics.2022; 102: 104758.     CrossRef
  • Relationship between Nutritional Status, Food Consumption and Sarcopenia in Post-Stroke Rehabilitation: Preliminary Data
    Mariacristina Siotto, Marco Germanotta, Alessandro Guerrini, Simona Pascali, Valeria Cipollini, Laura Cortellini, Elisabetta Ruco, Yeganeh Manon Khazrai, Laura De Gara, Irene Aprile
    Nutrients.2022; 14(22): 4825.     CrossRef
  • Handgrip Strength: An Irreplaceable Indicator of Muscle Function
    Sang Yoon Lee
    Annals of Rehabilitation Medicine.2021; 45(3): 167.     CrossRef
  • 9,032 View
  • 240 Download
  • 12 Web of Science
  • 14 Crossref
Exercise Program Improves Functional Capacity and Quality of Life in Uncorrected Atrial Septal Defect-Associated Pulmonary Arterial Hypertension: A Randomized-Control Pilot Study
Annis Rakhmawati, Indera Noor Achmad, Anggoro Budi Hartopo, Dyah Wulan Anggrahini, Irsad Andi Arso, Noriaki Emoto, Lucia Kris Dinarti
Ann Rehabil Med 2020;44(6):468-480.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20100
Objective
To assess the effect of combined hospital and home-based exercise programs on functional capacity and quality of life (QoL) among uncorrected atrial septal defect-associated pulmonary arterial hypertension (ASD-PAH) patients.
Methods
This study was a randomized controlled trial with uncorrected ASD-PAH patients as the subjects. They were allocated randomly into control and exercise groups. Exercise group subjects performed hospital and home-based exercise programs, completing baseline 6-minute walking test (6MWT) and EQ-5D-3L QoL test (Utility Index and EQ-VAS scores), and were followed up for 12 weeks. The primary outcomes were 6MWT distance and EQ-5D-3L score at week 12. The N-terminal pro B-type natriuretic peptide (NT-proBNP) level was also assessed. A repeated-measure ANOVA was performed to detect endpoint differences over time.
Results
The exercise group contained 20 subjects and control group contained 19. In total, 19 exercise group subjects and 16 control group subjects completed the protocol. The 6MWT distance, Utility Index score, and EQ-VAS score incrementally improved significantly in the exercise group from baseline until week 12, with mean differences of 76.7 m (p<0.001), 0.137 (p<0.001) and 15.5 (p<0.001), respectively. Compared with the control group, the exercise group had significantly increased 6MWT distance and utility index score at week 12. The EQ-VAS score increased in the exercise group at week 12. The NT-proBNP level decreased at week 12 in the exercise group.
Conclusion
Combined hospital and home-based exercise program added to PAH-targeted therapy, improving functional capacity and QoL in uncorrected ASD-PAH patients.

Citations

Citations to this article as recorded by  
  • Effectiveness and safety of home-based versus centre-based exercise programmes for pulmonary hypertension: a systematic review with meta-analysis
    Indyanara C. Ribeiro, Sofia M. Sieczkowska, Renata Jashchenko, Daniela Jara, Denielli da Silva Gonçalves Bos, Rogério De Souza, Celso R.F. Carvalho, Kátia De Angelis, Marcelle Paula-Ribeiro
    European Respiratory Review.2025; 34(177): 250102.     CrossRef
  • Pulmonary Hypertension: Exercise Intolerance and the Benefits of Respiratory Muscle and Exercise Training
    Seshika Ratwatte, Derek Tran, David S. Celermajer, Rachael Cordina
    Advances in Pulmonary Hypertension.2024; 23(1): 11.     CrossRef
  • The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review
    Angela T. Burge, Adelle M. Gadowski, Lorena Romero, Guido Vagheggini, Anna Spathis, Natasha E. Smallwood, Magnus Ekström, Anne E. Holland
    European Respiratory Review.2024; 33(174): 240027.     CrossRef
  • Examining the Role of Exercise Training in Enhancing Life for Adult Congenital Heart Disease: Systematic Review
    Tugba Siyah, Naciye Vardar Yagli, Ilker Ertugrul, Hayrettin Hakan Aykan, Melda Saglam
    Arquivos Brasileiros de Cardiologia.2024;[Epub]     CrossRef
  • O Papel do Treinamento Físico na Melhoria da Qualidade de Vida para Cardiopatia Congênita Adulta: Revisão Sistemática
    Tugba Siyah, Naciye Vardar Yagli, Ilker Ertugrul, Hayrettin Hakan Aykan, Melda Saglam
    Arquivos Brasileiros de Cardiologia.2024;[Epub]     CrossRef
  • Exercise-based rehabilitation programmes for pulmonary hypertension
    Norman R Morris, Fiona D Kermeen, Arwel W Jones, Joanna YT Lee, Anne E Holland
    Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
  • Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines
    Lucia Kris Dinarti, Dyah Wulan Anggrahini, Oktavia Lilyasari, Bambang Budi Siswanto, Anggoro Budi Hartopo
    Global Heart.2021;[Epub]     CrossRef
  • 8,453 View
  • 195 Download
  • 5 Web of Science
  • 7 Crossref
Ultrasonographic Analysis of Optimal Needle Placement for Extensor Indicis
Jin Young Kim, Hyun Seok, Sang-Hyun Kim, Yoon-Hee Choi, Jun Young Ahn, Seung Yeol Lee
Ann Rehabil Med 2020;44(6):450-458.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20035
Objective
To determine the most optimal needle insertion point of extensor indicis (EI) using ultrasound.
Methods
A total 80 forearms of 40 healthy volunteers were recruited. We identified midpoint (MP) of EI using ultrasound and set MP as optimal needle insertion point. The location of MP was suggested using distances from landmarks. Distance from MP to medial border of ulna (MP-X) and to lower margin of ulnar head (MP-Y) were measured. Ratios of MP-X to Forearm circumference (X ratio) and MP-Y to forearm length (Y ratio) were calculated. In cross-sectional view, depth of MP (Dmp), defined as middle value of superficial depth (Ds) and deep depth (Dd) was measured and suggested as proper depth of needle insertion.
Results
Mean MP-X was 1.37±0.14 cm and mean MP-Y was 5.50±0.46 cm. Mean X ratio was 8.10±0.53 and mean Y ratio was 22.15±0.47. Mean Dmp was 7.63±0.96 mm.
Conclusion
We suggested that novel optimal needle insertion point of the EI. It is about 7.6 mm in depth at about 22% of the forearm length proximal from the lower margin of the ulnar head and about 8.1% of the forearm circumference radial from medial border of ulna.
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Effort Assessment of Stroke Patients in Physiotherapy Session by Accelerometry and Perceived Exertion Score: Preliminary Study
Justine Lacroix, Jean-Christophe Daviet, Jean-Yves Salle, Benoit Borel, Maxence Compagnat, Stephane Mandigout
Ann Rehabil Med 2019;43(3):262-268.   Published online June 28, 2019
DOI: https://doi.org/10.5535/arm.2019.43.3.262
Objective
To determine whether post-stroke patient’s perceived exertion correlates with effort intensity score as measured by a wearable sensor and to assess whether estimates of perceived exertion are correlated to the cerebral hemisphere involved in the stroke.
Methods
We evaluated the effort intensity score during physiotherapy sessions using a wearable sensor and subjects assessed their perceived exertion using the modified Borg CR10 Scale.
Results
Fifty-seven subacute stroke patients participated in the study. The correlation between perceived exertion rating and measured effort intensity was insignificant—mean (r=-0.04, p=0.78) and peak (r=-0.05, p=0.70). However, there was a significant difference (p<0.02) in the perceived exertion ratings depending on the cerebral hemisphere where the stroke occurred. Patients with left-hand side lesions rated their perceived exertion as 4.5 (min–max, 0.5–8), whereas patients with right-hand side lesions rated their perceived exertion as 5.0 (2–8).
Conclusion
While there was an insignificant correlation between perceived exertion and effort intensity measured by a wearable sensor, a consistent variations in perceived exertion estimates according to the side of the cerebral lesion was identified and established.

Citations

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  • Understanding task “challenge” in stroke rehabilitation: an interdisciplinary concept analysis
    Emeline Gomes, Gemma Alder, Felicity A. S. Bright, Nada Signal
    Disability and Rehabilitation.2025; 47(3): 560.     CrossRef
  • Exploring Unsupervised Home-Based Exercise Therapy in Chronic Post-Stroke Individuals: A Scoping Review
    Noémie C Duclos, Pierre Barat, Stéphanie Goncalves, Eric Sorita, Karim Jamal
    NeuroRehabilitation.2025; 57(4): 423.     CrossRef
  • Energy expenditure and effort of patients with stroke during sit to stand: A pilot study
    Tracy Harington, Nicolette Comley-White, Ronel Roos
    South African Journal of Physiotherapy.2024;[Epub]     CrossRef
  • The Use of Samsung Health and ECG M-Trace Base II Applications for the Assessment of Exercise Tolerance in the Secondary Prevention in Patients after Ischemic Stroke
    Mateusz Lucki, Ewa Chlebuś, Agnieszka Wareńczak, Przemysław Lisiński
    International Journal of Environmental Research and Public Health.2021; 18(11): 5753.     CrossRef
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  • 129 Download
  • 4 Web of Science
  • 4 Crossref
Effects of Long-Distance Running on Cardiac Markers and Biomarkers in Exercise-Induced Hypertension Runners: An Observational Study
Min-ho Park, Kyung-A Shin, Chul-Hyun Kim, Yoon-Hee Lee, Yongbum Park, Jaeki Ahn, Young-Joo Kim
Ann Rehabil Med 2018;42(4):575-583.   Published online August 31, 2018
DOI: https://doi.org/10.5535/arm.2018.42.4.575
Objective
To investigate changes of cardiac and muscle damage markers in exercise-induced hypertension (EIH) runners before running (pre-race), immediately after completing a 100-km ultramarathon race, and during the recovery period (24, 72, and 120 hours post-race).
Methods
In this observational study, volunteers were divided into EIH group (n=11) whose maximum systolic blood pressure was ≥210 mmHg in graded exercise testing and normal exercise blood pressure response (NEBPR) group (n=11). Their blood samples were collected at pre-race, immediately after race, and at 24, 72, and 120 hours post-race.
Results
Creatine kinase (CK) and cardiac troponin I (cTnI) levels were significantly higher in EIH group than those in the NEBPR group immediately after race and at 24 hours post-race (all p<0.05). However, lactate dehydrogenase (LDH), creatine kinase-myocardial band (CKMB), or CKMB/CK levels did not show any significant differences between the two groups in each period. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in EIH group than those in NEBPR group immediately after race and at 24 and 72 hours postrace (all p<0.05). A high sensitivity C-reactive protein (hs-CRP) level was significantly higher in EIH group than that in NEBPR group at 24 hours post-race (p<0.05).
Conclusion
The phenomenon of higher inflammatory and cardiac marker levels in EIH group may exaggerate cardiac volume pressure and blood flow restrictions which in turn can result in cardiac muscle damage. Further prospective studies are needed to investigate the chronic effect of such phenomenon on the cardiovascular system in EIH runners.

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  • Asymptomatic HyperCKemia: A Case Report and Literature Review
    成锋 李
    Advances in Clinical Medicine.2025; 15(07): 408.     CrossRef
  • Possible Mechanisms for Adverse Cardiac Events Caused by Exercise-Induced Hypertension in Long-Distance Middle-Aged Runners: A Review
    Young-Joo Kim, Kyoung-Min Park
    Journal of Clinical Medicine.2024; 13(8): 2184.     CrossRef
  • Relationship between echocardiographic characteristics and cardiac biomarkers during long-distance trail running
    Romain Jouffroy, Hélène Hergault, Juliana Antero, Antoine Vieillard Baron, Nicolas Mansencal
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Electrical Cardiometry and Cardiac Biomarkers in 24-h and 48-h Ultramarathoners
    Che-Hung Liu, Li-Hua Li, Ming-Long Chang, Wei-Fong Kao, Chorng-Kuang How, Jiun-I Lai, Yen-Kuang Lin, Yu-Hui Chiu, Wen-Han Chang
    International Journal of Sports Medicine.2021; 42(11): 1035.     CrossRef
  • Exercise-Induced Cardiac Troponin Elevations: From Underlying Mechanisms to Clinical Relevance
    Vincent L. Aengevaeren, Aaron L. Baggish, Eugene H. Chung, Keith George, Øyunn Kleiven, Alma M.A. Mingels, Stein Ørn, Rob E. Shave, Paul D. Thompson, Thijs M.H. Eijsvogels
    Circulation.2021; 144(24): 1955.     CrossRef
  • Long‐term biological variability and the generation of a new reference interval for plasma N‐terminal pro‐B‐type natriuretic peptide in Labrador retrievers
    S. Gomart, D. Allaway, M. Harrison, D. Dickson, J. Seo, L. Ferasin, J. R. Payne, M. J. Hezzell, K. Borgeat
    Journal of Small Animal Practice.2020; 61(6): 368.     CrossRef
  • Acute Responses of Novel Cardiac Biomarkers to a 24-h Ultra-Marathon
    Aleksandra Żebrowska, Zbigniew Waśkiewicz, Pantelis T. Nikolaidis, Rafał Mikołajczyk, Damian Kawecki, Thomas Rosemann, Beat Knechtle
    Journal of Clinical Medicine.2019; 8(1): 57.     CrossRef
  • Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation
    Øyunn Kleiven, Torbjørn Omland, Øyvind Skadberg, Tor Harald Melberg, Magnus Friestad Bjørkavoll-Bergseth, Bjørn Auestad, Rolf Bergseth, Ole Jakob Greve, Kristin Moberg Aakre, Stein Ørn
    International Journal of Cardiology.2019; 283: 1.     CrossRef
  • 12,434 View
  • 143 Download
  • 7 Web of Science
  • 8 Crossref
Optimal Placement of Needle Electromyography in Extensor Indicis: A Cadaveric Study
Jin Young Im, Hong Bum Park, Seok Jun Lee, Seong Gyu Lim, Ki Hoon Kim, Dasom Kim, Im Joo Rhyu, Byung Kyu Park, Dong Hwee Kim
Ann Rehabil Med 2018;42(3):473-476.   Published online June 27, 2018
DOI: https://doi.org/10.5535/arm.2018.42.3.473
Objective
To identify the center of extensor indicis (EI) muscle through cadaver dissection and compare the accuracy of different techniques for needle electromyography (EMG) electrode insertion.
Methods
Eighteen upper limbs of 10 adult cadavers were dissected. The center of trigonal EI muscle was defined as the point where the three medians of the triangle intersect. Three different needle electrode insertion techniques were introduced: M1, 2.5 cm above the lower border of ulnar styloid process (USP), lateral aspect of the ulna; M2, 2 finger breadths (FB) proximal to USP, lateral aspect of the ulna; and M3, distal fourth of the forearm, lateral aspect of the ulna. The distance from USP to the center (X) parallel to the line between radial head to USP, and from medial border of ulna to the center (Y) were measured. The distances between 3 different points (M1– M3) and the center were measured (marked as D1, D2, and D3, respectively).
Results
The median value of X was 48.3 mm and that of Y was 7.2 mm. The median values of D1, D2 and D3 were 23.3 mm, 13.3 mm and 9.0 mm, respectively.
Conclusion
The center of EI muscle is located approximately 4.8 cm proximal to USP level and 7.2 mm lateral to the medial border of the ulna. Among the three methods, the technique placing the needle electrode at distal fourth of the forearm and lateral to the radial side of the ulna bone (M3) is the most accurate and closest to the center of the EI muscle.

Citations

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  • Ultrasonographic Analysis of Optimal Needle Placement for Extensor Indicis
    Jin Young Kim, Hyun Seok, Sang-Hyun Kim, Yoon-Hee Choi, Jun Young Ahn, Seung Yeol Lee
    Annals of Rehabilitation Medicine.2020; 44(6): 450.     CrossRef
  • 11,484 View
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  • 1 Web of Science
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Case Report

Complex Regional Pain Syndrome of Non-hemiplegic Upper Limb in a Stroke Patient: A Case Report
Ahry Lee, Youjin Jung, Hee-Kyu Kwon, Sung-Bom Pyun
Ann Rehabil Med 2018;42(1):175-179.   Published online February 28, 2018
DOI: https://doi.org/10.5535/arm.2018.42.1.175

Complex regional pain syndrome (CRPS) type I in stroke patients is usually known to affect the hemiplegic upper limb. We report a case of CRPS presented in an ipsilesional arm of a 72-year-old female patient after an ischemic stroke at the left middle cerebral artery territory. Clinical signs such as painful range of motion and hyperalgesia of her left upper extremity, swollen left hand, and dystonic posture were suggestive of CRPS. A three-phase bone scintigraphy showed increased uptake in all phases in the ipsilesional arm. Diffusion tensor tractography showed significantly decreased fiber numbers of the corticospinal tract and the spinothalamic tract in both unaffected and affected hemispheres. Pain and range of motion of the left arm of the patient improved after oral steroids with a starting dose of 50 mg/day.

Citations

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  • The Usefulness of Diffusion Tensor Tractography in Diagnosing Neuropathic Pain: A Narrative Review
    Seoyon Yang, SuYeon Kwon, Min Cheol Chang
    Frontiers in Neuroscience.2021;[Epub]     CrossRef
  • Alteration of White Matter in Patients with Central Post-Stroke Pain
    Jung Geun Park, Bo Young Hong, Hae-Yeon Park, Yeun Jie Yoo, Mi-Jeong Yoon, Joon-Sung Kim, Seong Hoon Lim
    Journal of Personalized Medicine.2021; 11(5): 417.     CrossRef
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  • 2 Web of Science
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Original Article

Superior Effects of High-Intensity Interval Training Compared to Conventional Therapy on Cardiovascular and Psychological Aspects in Myocardial Infarction
Ha-Yoon Choi, Hee-Jun Han, Ji-won Choi, Han-Young Jung, Kyung-Lim Joa
Ann Rehabil Med 2018;42(1):145-153.   Published online February 28, 2018
DOI: https://doi.org/10.5535/arm.2018.42.1.145
Objective

To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification.

Methods

This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions.

Results

Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO2max was significantly (p<0.005) improved in the HIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (p<0.005).

Conclusion

This study demonstrates that HIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.

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Case Reports

The authors report the diffusion tensor tractography (DTT) findings of three pediatric patients with gait dysfunction and corticoreticular tract (CRT) disruption. All three patients showed unilateral trunk instability, but they did not show any spasticity or weakness of the distal extremities. Clinical evaluation of trunk instability using a Trunk Control Measurement Scale (TCMS) revealed that the more affected side had a lower score than the contralateral side. DTT showed disrupted CRTs in hemispheres contralateral to the hemiparetic sides, which were associated with unilateral proximal instability, although conventional MRI showed no abnormal lesion explaining the hemiplegic symptom. Compared to the results in age-matched controls, these three patients had decreased values of fractional anisotropy (FA) and tract volumes (TV) of the affected CRTs, and these values were also decreased compared to those in the contralateral side. On the other hand, values of FA and TV of the corticospinal tracts on the ipsilateral and contralateral sides were only marginally different. In conclusion, diffusion tensor imaging can be helpful for investigating the state of the CRT in pediatric patients with trunk instability and gait dysfunction.

Citations

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    Su Min Son, Jung Won Lee, Min Cheol Chang
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    SoYeon Jun, BoYoung Hong, YoungKook Kim, SeongHoon Lim
    Brain Sciences.2021; 11(7): 867.     CrossRef
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    Sun-Young Ha, Yun-Hee Sung
    Children.2021; 8(10): 918.     CrossRef
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Neuroanatomical Mechanism of Cerebellar Mutism After Stroke
Sekwang Lee, Yoon Hye Na, Hyun Im Moon, Woo Suk Tae, Sung-Bom Pyun
Ann Rehabil Med 2017;41(6):1076-1081.   Published online December 28, 2017
DOI: https://doi.org/10.5535/arm.2017.41.6.1076

Cerebellar mutism (CM) is a rare neurological condition characterized by lack of speech due to cerebellar lesions. CM is often reported in children. We describe a rare case of CM after spontaneous cerebellar hemorrhage. The patient showed mutism, irritability, decreased spontaneous movements and oropharyngeal apraxia. Diffusion tensor imaging revealed significant volume reduction of medial frontal projection fibers from the corpus callosum. In Tracts Constrained by UnderLying Anatomy (TRACULA) analysis, forceps major and minor and bilateral cingulum-angular bundles were not visualized. Cerebello-frontal pathway reconstructed from the FMRIB Software Library showed continuity of fibers, with decreased number of fibers on qualitative analysis. These results suggest that cerebello-frontal disconnection may be a neuroanatomical mechanism of CM. Damage of brain network between occipital lobe, cingulate and cerebellum caused by hemorrhage may also have role in the mechanism of CM in our case.

Citations

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  • Cerebellar Mutism Syndrome in a Patient With Hypertensive Urgency and Ischemia: A Case Report
    Shounak Ghosh, Bertrand Liang
    Cureus.2024;[Epub]     CrossRef
  • Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study
    Jonathan Kjær Grønbæk, Aske Foldbjerg Laustsen, Sebastian Toescu, Barry Pizer, Conor Mallucci, Kristian Aquilina, Emanuela Molinari, Magnus Aasved Hjort, Lingvita Gumbeleviciene, Peter Hauser, Beatrix Pálmafy, Kirsten van Baarsen, Eelco Hoving, Julian Zip
    Child's Nervous System.2022; 38(8): 1479.     CrossRef
  • Mutism resulting from heterochronic bilateral cerebellar hemorrhages – A case report
    Masahito Katsuki, Ayumi Narisawa, Hiroshi Karibe, Motonobu Kameyama, Teiji Tominaga
    Surgical Neurology International.2019; 10: 122.     CrossRef
  • Quantitative MRI in post-operative paediatric cerebellar mutism syndrome
    Sebastian M. Toescu, Patrick W. Hales, Kristian Aquilina, Chris A. Clark
    European Journal of Radiology.2018; 108: 43.     CrossRef
  • Clinical significance of serum-terminal pro-B-type natriuretic peptide in patients with acute cerebral stroke
    Qi Yang, Chang Li, Le Wang, Bo Wei
    Panminerva Medica.2018;[Epub]     CrossRef
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  • 106 Download
  • 3 Web of Science
  • 5 Crossref
Medial Lemniscus Tract Lesion After High Voltage Electrical Injury: A Case Report
Chul-Hyun Cho, Dong Gyu Lee
Ann Rehabil Med 2017;41(2):318-322.   Published online April 27, 2017
DOI: https://doi.org/10.5535/arm.2017.41.2.318

We present the case of a 33-year-old man who experienced a 10,000-V electrical shock when working with electrical wiring. He suffered third-degree burns on his scalp at the right occiput (entry wound) and on his left arm (exit would), and a second-degree burn on his left foot (exit wound). He presented with severe spasticity of both lower extremities, motor weakness with a Medical Research Council grade of 3, and sensory impairments below thoracic level 11 that included an inability to sense light touch and defects in proprioception. Initial magnetic resonance imaging (MRI) scans of his spine and brain showed no definite abnormalities. However, tractography obtained by diffusion tensor imaging of the brain showed absence of the right medial lemniscus tract. A cervical MRI scan 1 month later showed spinal cord swelling from cervical 1-5 levels, and signal changes in the lateral and posterior white matter in the axial view. After 6 months of rehabilitation, he recovered almost normal degree of motor function in his lower extremities and disappearance of spasticity. However, since the sensory impairments persisted, especially defects in proprioception, he was unable to walk independently.

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  • Alterations in white matter integrity in Egyptian youth with smartphone dependence: does DTI have a role?
    Alaa Mohamed Reda, Ahmed Elsharkawy, Mostafa Mamdouh Kamel, Sara Essam Hasby
    Egyptian Journal of Radiology and Nuclear Medicine.2024;[Epub]     CrossRef
  • Injury of Corticospinal tract and Corticoreticular pathway caused by high-voltage electrical shock: a case report
    Mathieu Boudier-Revéret, Ming-Yen Hsiao, Shaw-Gang Shyu, Min Cheol Chang
    BMC Neurology.2020;[Epub]     CrossRef
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    Yuanming Hu, Xiaojing Long, Hanqing Lyu, Yangyang Zhou, Jianxiang Chen
    Frontiers in Human Neuroscience.2017;[Epub]     CrossRef
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  • 55 Download
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  • 3 Crossref
Diagnostic Challenge of Diffusion Tensor Imaging in a Patient With Hemiplegia After Traumatic Brain Injury
Hye Eun Shin, Hoon Chang Suh, Si Hyun Kang, Kyung Mook Seo, Don-Kyu Kim, Hae-Won Shin
Ann Rehabil Med 2017;41(1):153-157.   Published online February 28, 2017
DOI: https://doi.org/10.5535/arm.2017.41.1.153

A 51-year-old man showed hemiplegia on his right side after a traumatic brain injury (TBI). On initial brain computed tomography (CT) scan, an acute subdural hemorrhage in the right cerebral convexity and severe degrees of midline shifting and subfalcine herniation to the left side were evident. On follow-up brain magnetic resonance imaging (MRI), there were multiple microhemorrhages in the left parietal and occipital subcortical regions. To explain the occurrence of right hemiplegia after brain damage which dominantly on the right side of brain, we used diffusion tensor imaging (DTI) to reconstruct the corticospinal tract (CST), which showed nearly complete injury on the left CST. We also performed motor-evoked potentials, and stimulation of left motor cortex evoked no response on both sides of upper extremity. We report a case of patient with hemiplegia after TBI and elucidation of the case by DTI rather than CT and MRI.

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  • Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
    Chan-Hyuk Park, Su-Hong Kim, Han-Young Jung
    Diagnostics.2020; 10(3): 156.     CrossRef
  • Delayed Extensive White Matter Injury Caused by a Subdural Hemorrhage and Role of Corticospinal Tract Integrity
    Kyoung Bo Lee, Sang Cheol Yoon, Joon Sung Kim, Bo Young Hong, Jung Geun Park, Won Jin Sung, Hye Jung Park, Seong Hoon Lim
    Brain & Neurorehabilitation.2019;[Epub]     CrossRef
  • 6,768 View
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  • 4 Web of Science
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Original Articles

Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome
Hyewon Lee, Sungju Jee, Soo Ho Park, Seung-Chan Ahn, Juneho Im, Min Kyun Sohn
Ann Rehabil Med 2016;40(6):1048-1056.   Published online December 30, 2016
DOI: https://doi.org/10.5535/arm.2016.40.6.1048
Objective

To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed.

Methods

Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated.

Results

Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all p<0.05). EI demonstrated a significant positive correlation with latency of the median motor and sensory NCS in CTS patients (p<0.05).

Conclusion

These findings suggest that quantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US.

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  • The Association Between Ultrasound Findings of Thumb Muscles, Handgrip Strength, and Pain Threshold in Thumb Carpometacarpal Osteoarthritis: A Cross-Sectional Study
    Gulcan Ozturk, Duygu Silte Karamanlioglu, Pinar Akpinar, Feyza Akan Begoglu, Feyza Unlu Ozkan, Ilknur Aktas
    Indian Journal of Orthopaedics.2026;[Epub]     CrossRef
  • Diagnosis of carpal tunnel syndrome using deep learning with comparative guidance
    Jungsub Sim, Sungche Lee, Seunghyun Kim, Seong-ho Jeong, Joonshik Yoon, Seungjun Baek
    Clinical Neurophysiology.2025; 174: 191.     CrossRef
  • Thenar Muscle Atrophy: Clinical, Electrodiagnostic, and Ultrasound Features in 197 Patients
    Lisa B. E. Shields, Vasudeva G. Iyer, Stephen Furmanek, Yi Ping Zhang, Christopher B. Shields
    Neurology International.2025; 17(12): 201.     CrossRef
  • Morphometry of thenar muscles by water bath ultrasonography in trapeziometacarpal osteoarthritis: intra- and inter-rater reliability
    Feray Karademir, Cigdem Ayhan Kuru, Gamze Arın, Ruhi Soylu
    Journal of Hand Surgery (European Volume).2023; 48(2): 115.     CrossRef
  • MRI of wrist and diffusion tensor imaging of the median nerve in patients with carpal tunnel syndrome
    Suprava Naik, Siladitya Mahanty, Sanjeev Kumar Bhoi, Yuvraj Lahre, Nerbadyswari Deep Bag, Sudipta Mohakud
    Journal of Neurosciences in Rural Practice.2023; 14: 302.     CrossRef
  • Predictive value of ultrasonography in polyneuropathy diagnosis: electrophysiological and ultrasonographic analysis
    Kaan Yavuz, Fatma Gul Yurdakul, Tuba Guler, Hatice Bodur
    Rheumatology International.2023; 43(9): 1733.     CrossRef
  • Ultrasound of Thumb Muscles and Grasp Strength in Early Thumb Carpometacarpal Osteoarthritis
    Cara Lai, Deborah Kenney, Faes Kerkhof, Andrea Finlay, Amy Ladd, Eugene Roh
    The Journal of Hand Surgery.2022; 47(9): 898.e1.     CrossRef
  • Sonographic evaluation of the abductor pollicis brevis muscle reflects muscle strength recovery after carpal tunnel release
    Katsunori Ohno, Keitaro Fujino, Kenta Fujiwara, Atsushi Yokota, Masashi Neo
    Journal of Medical Ultrasonics.2022; 49(2): 279.     CrossRef
  • Human skeletal muscle size with ultrasound imaging: a comprehensive review
    Masatoshi Naruse, Scott Trappe, Todd A. Trappe
    Journal of Applied Physiology.2022; 132(5): 1267.     CrossRef
  • Ultrasound Imaging Analysis of the Lumbar Multifidus Muscle Echo Intensity: Intra-Rater and Inter-Rater Reliability of a Novice and an Experienced Rater
    Maryse Fortin, Brent Rosenstein, Jerome Levesque, Neil Nandlall
    Medicina.2021; 57(5): 512.     CrossRef
  • Quantitative sonographic evaluation of muscle thickness and fasciculation prevalence in healthy subjects
    Alon Abraham, Vivian E. Drory, Yaara Fainmesser, Leif E. Lovblom, Vera Bril
    Muscle & Nerve.2020; 61(2): 234.     CrossRef
  • Diagnosis and grading of carpal tunnel syndrome with quantitative ultrasound: Is it possible?
    Tugba Ozsoy-Unubol, Yeliz Bahar-Ozdemir, Ilker Yagci
    Journal of Clinical Neuroscience.2020; 75: 25.     CrossRef
  • High‐Resolution Nerve Ultrasound to Assess Nerve Echogenicity, Fascicular Count, and Cross‐Sectional Area Using Semiautomated Analysis
    Donata Gamber, Jeremias Motte, Antonios Kerasnoudis, Min‐Suk Yoon, Ralf Gold, Kalliopi Pitarokoili, Anna Lena Fisse
    Journal of Neuroimaging.2020; 30(4): 493.     CrossRef
  • Quantitative Evaluation of the Echo Intensity of Paraneural Area and Myofascial Structure around Median Nerve in Carpal Tunnel Syndrome
    Chenglei Fan, Caterina Fede, Carmelo Pirri, Diego Guidolin, Carlo Biz, Veronica Macchi, Raffaele De Caro, Carla Stecco
    Diagnostics.2020; 10(11): 914.     CrossRef
  • Sonographic morphometry of abductor pollicis brevis: can direct contact yield images comparable with those obtained by the water bath technique?
    Keitaro Fujino, Katsunori Ohno, Kenta Fujiwara, Atsushi Yokota, Masashi Neo
    Journal of Medical Ultrasonics.2019; 46(4): 489.     CrossRef
  • Quantitative muscle ultrasound in upper extremity mononeuropathies
    Yun Wang, Hilda Gutierrez, Maria Martucci, Alison Poussaint, Kristin Qi, Benjamin Sanchez, Seward B. Rutkove
    Muscle & Nerve.2019; 60(1): 67.     CrossRef
  • Pilot study: Differences in echo intensity ratios between ulnar and median innervated muscles in ulnar neuropathy
    Hanboram Choi, Jun Ho Choi, Seok Kang, Joon Shik Yoon, Seong‐Ho Son
    Muscle & Nerve.2019; 60(4): 387.     CrossRef
  • Quantitative muscle ultrasound is useful for evaluating secondary axonal degeneration in chronic inflammatory demyelinating polyneuropathy
    Keiichi Hokkoku, Kiyoshi Matsukura, Yudai Uchida, Midori Kuwabara, Yuichi Furukawa, Hiroshi Tsukamoto, Yuki Hatanaka, Masahiro Sonoo
    Brain and Behavior.2017;[Epub]     CrossRef
  • 6,708 View
  • 59 Download
  • 18 Web of Science
  • 18 Crossref
Association of Dysphagia With Supratentorial Lesions in Patients With Middle Cerebral Artery Stroke
Bo-Ram Kim, Won-Jin Moon, Hyuntae Kim, Eunhwa Jung, Jongmin Lee
Ann Rehabil Med 2016;40(4):637-646.   Published online August 24, 2016
DOI: https://doi.org/10.5535/arm.2016.40.4.637
Objective

To determine the supratentorial area associated with poststroke dysphagia, we assessed the diffusion tensor images (DTI) in subacute stroke patients with supratentorial lesions.

Methods

We included 31 patients with a first episode of infarction in the middle cerebral artery territory. Each subject underwent brain DTI as well as a videofluoroscopic swallowing study (VFSS) and patients divided were into the dysphagia and non-dysphagia groups. Clinical dysphagia scale (CDS) scores were compared between the two groups. The corticospinal tract volume (TV), fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for 11 regions of interest in the supratentorial area—primary motor cortex, primary somatosensory cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule, thalamus, and basal ganglia (putamen and caudate nucleus). DTI parameters were compared between the two groups.

Results

Among the 31 subjects, 17 were diagnosed with dysphagia by VFSS. Mean TVs were similar across the two groups. Significant inter-group differences were observed in two DTI values: the FA value in the contra-lesional primary motor cortex and the ADC value in the bilateral posterior limbs of the internal capsule (all p<0.05).

Conclusion

The FA value in the primary motor cortex on the contra-lesional side and the ADC value in the bilateral PLIC can be associated with dysphagia in middle cerebral artery stroke.

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  • Buyang Huanwu Decoction enhances hippocampal-cortical connectivity remodeling via sonic hedgehog signaling to ameliorate memory dysfunction in cerebral ischemic rats
    Yun Lu, Ziyue Lin, Hanyu Wang, Yuming Zhuang, Jingting Jia, Yuxuan Wang, Le Yang, Manzhong Li, Mingcong Li, Binbin Nie, Rui Zhang, Xu Pan, Jianfeng Lei, Haiyan Zou, Hui Zhao
    Chinese Medicine.2025;[Epub]     CrossRef
  • Combination of fMRI and PET reveals the beneficial effect of three‐phase enriched environment on post‐stroke memory deficits by enhancing plasticity of brain connectivity between hippocampus and peri‐hippocampal cortex
    Yun Lu, Mingcong Li, Yuming Zhuang, Ziyue Lin, Binbin Nie, Jianfeng Lei, Yuanyuan Zhao, Hui Zhao
    CNS Neuroscience & Therapeutics.2024;[Epub]     CrossRef
  • Brain Abnormalities in Pontine Infarction: A Longitudinal Diffusion Tensor Imaging and Functional Magnetic Resonance Imaging study
    Jing Li, Dong-Dong Rong, Yi Shan, Miao Zhang, Cheng Zhao, Jie Lu
    Journal of Stroke and Cerebrovascular Diseases.2022; 31(2): 106205.     CrossRef
  • Swallowing function in the chronic stage following stroke is associated with white matter integrity of the callosal tract between the interhemispheric S1 swallowing representation areas
    M. Domin, G.P. Mihai, T. Platz, M. Lotze
    NeuroImage: Clinical.2022; 35: 103093.     CrossRef
  • Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis
    Jia Qiao, Zhimin Wu, Xue Cheng, Qiuping Ye, Meng Dai, Yong Dai, Zulin Dou
    Brain Sciences.2022; 12(10): 1334.     CrossRef
  • Portable fibrobronchoscopic treatment for non-severe ischemic stroke-associated pneumonia patients with dysphagia: a pilot study
    Qiu Han, Chun Chen, Ran Fu, Lan Tan, Lei Xia
    Neurological Research.2019; 41(3): 216.     CrossRef
  • Comparison of Dysphagia Between Infratentorial and Supratentorial Stroke Patients
    Yong Kyun Kim, Jung Hyun Cha, Kyun Yeon Lee
    Annals of Rehabilitation Medicine.2019; 43(2): 149.     CrossRef
  • Association Between Duration of Dysphagia Recovery and Lesion Location on Magnetic Resonance Imaging in Patients With Middle Cerebral Artery Infarction
    Jae Ho Kim, Se Hyun Oh, Ho Joong Jeong, Young Joo Sim, Dung Gyu Kim, Ghi Chan Kim
    Annals of Rehabilitation Medicine.2019; 43(2): 142.     CrossRef
  • Association of Brain Lesions and Videofluoroscopic Dysphagia Scale Parameters on Patients With Acute Cerebral Infarctions
    Sang Jun Mo, Ho Joong Jeong, Yong Hyun Han, Kihun Hwang, Jong Kyoung Choi
    Annals of Rehabilitation Medicine.2018; 42(4): 560.     CrossRef
  • Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke
    Marian Galovic, Natascha Leisi, Manuela Pastore‐Wapp, Martin Zbinden, Sjoerd B. Vos, Marlise Mueller, Johannes Weber, Florian Brugger, Georg Kägi, Bruno J. Weder
    Human Brain Mapping.2017; 38(4): 2165.     CrossRef
  • 8,015 View
  • 109 Download
  • 12 Web of Science
  • 10 Crossref
Optimal Needle Placement for Extensor Hallucis Longus Muscle: A Cadaveric Study
In Yae Cheong, Do Kyun Kim, Ye Jeong Oh, Byung Kyu Park, Ki Hoon Kim, Dong Hwee Kim
Ann Rehabil Med 2016;40(3):457-462.   Published online June 29, 2016
DOI: https://doi.org/10.5535/arm.2016.40.3.457
Objective

To determine the midpoint (MD) of extensor hallucis longus muscle (EHL) and compare the accuracy of different needle electromyography (EMG) insertion techniques through cadaver dissection.

Methods

Thirty-eight limbs of 19 cadavers were dissected. The MD of EHL was marked at the middle of the musculotendinous junction and proximal origin of EHL. Three different needle insertion points of EHL were marked following three different textbooks: M1, 3 fingerbreadths above bimalleolar line (BML); M2, junction between the middle and lower third of tibia; M3, 15 cm proximal to the lower border of both malleoli. The distance from BML to MD (BML_MD), and the difference between 3 different points (M1–3) and MD were measured (designated D1, D2, and D3, respectively). The lower leg length (LL) was measured from BML to top of medial condyle of tibia.

Results

The median value of LL was 34.5 cm and BML_MD was 12.0 cm. The percentage of BML_MD to LL was 35.1%. D1, D2, and D3 were 7.0, 0.9, and 3.0 cm, respectively. D2 was the shortest, meaning needle placement following technique by Lee and DeLisa was closest to the actual midpoint of EHL.

Conclusion

The MD of EHL is approximately 12 cm above BML, and about distal 35% of lower leg length. Technique that recommends placing the needle at distal two-thirds of the lower leg (M2) is the most accurate method since the point was closest to muscle belly of EHL.

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    Wolfgang H. Jost, Emir Berberovic
    Toxins.2025; 17(4): 168.     CrossRef
  • The Elias University Hospital Approach: A Visual Guide to Ultrasound-Guided Botulinum Toxin Injection in Spasticity, Part IV—Distal Lower Limb Muscles
    Marius Nicolae Popescu, Claudiu Căpeț, Cristina Popescu, Mihai Berteanu
    Toxins.2025; 17(10): 508.     CrossRef
  • Optimal needle placement for extensor hallucis longus muscle using ultrasound verification
    Jin Myoung Kwak, Dong Hyun Kim, Yang Gyun Lee, Yoon‐Hee Choi
    Muscle & Nerve.2019; 59(3): 331.     CrossRef
  • Optimal Placement of Needle Electromyography in Extensor Indicis: A Cadaveric Study
    Jin Young Im, Hong Bum Park, Seok Jun Lee, Seong Gyu Lim, Ki Hoon Kim, Dasom Kim, Im Joo Rhyu, Byung Kyu Park, Dong Hwee Kim
    Annals of Rehabilitation Medicine.2018; 42(3): 473.     CrossRef
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  • 101 Download
  • 4 Web of Science
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Gross Motor Function Outcome After Intensive Rehabilitation in Children With Bilateral Spastic Cerebral Palsy
Seung Hoon Lee, Jae Sun Shim, Kiyoung Kim, Jinkyoo Moon, MinYoung Kim
Ann Rehabil Med 2015;39(4):624-629.   Published online August 25, 2015
DOI: https://doi.org/10.5535/arm.2015.39.4.624
Objective

To compare gross motor function outcomes in children with moderate to severe degrees of bilateral spastic cerebral palsy (CP) who received either intensive inpatient rehabilitation or intermittent rehabilitation on an outpatient basis.

Methods

A non-biased retrospective chart review was done for patients diagnosed with bilateral spastic CP who received rehabilitation therapy. The intensive rehabilitation group (inpatient group) agreed to be hospitalized to receive 22 sessions of physical and occupational therapy per week for 1 month. The intermittent rehabilitation group (outpatient group) received four sessions of physical and occupational therapy per week for 3 months in an outpatient setting. Changes in the total score on the Gross Motor Function Measure (GMFM) between baseline and the follow-up period were analyzed.

Results

Both groups showed significant improvements in total GMFM scores at the follow-up assessment compared to that at baseline (p=0.000 for inpatient group, p=0.001 for outpatient group). The increase in mean total GMFM score after 1 month was significantly greater in the inpatient group than that in the outpatient group (p=0.020). Higher increase in GMFM score was observed in younger subjects as revealed by the negative correlation between age and the increase in GMFM score after 1 month (p=0.002, r=-0.460).

Conclusion

Intensive inpatient rehabilitation therapy for patients with bilateral spastic CP of moderate to severe degree was more effective for improving gross motor function than intermittent rehabilitation therapy on an outpatient basis.

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    Oleksandra Sharova, Oleksandr Smiyan
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    Ana Carolina De Campos, Álvaro Hidalgo‐Robles, Egmar Longo, Claire Shrader, Ginny Paleg
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    Chris Church, Nancy Lennon, Madison Lennon, John D Henley, Thomas Shields, Tim Niiler, Daveda A Taylor, M Wade Shrader, Freeman Miller
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    Pierre Marois, Guy Letellier, Mikaël Marois, Laurent Ballaz
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    Yvonne J. M. Janssen-Potten, Lars Roks, Ruud Roijen, R. Jeroen Vermeulen, Eugène E. A. Rameckers
    Disability and Rehabilitation.2023; 45(21): 3529.     CrossRef
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    Beyzanur Dikmen Hoşbaş, Meral Sertel
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    Oleksandra Sharova, Oleksandr Smiyan, Thomas Borén
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    Che-Wei Hsu, Yi-No Kang, Sung-Hui Tseng
    Frontiers in Neurology.2019;[Epub]     CrossRef
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  • Autophagy-Related Gene 7 Polymorphisms and Cerebral Palsy in Chinese Infants
    Lei Xia, Jianhua Xu, Juan Song, Yiran Xu, Bohao Zhang, Chao Gao, Dengna Zhu, Chongchen Zhou, Dan Bi, Yangong Wang, Xiaoli Zhang, Qing Shang, Yimeng Qiao, Xiaoyang Wang, Qinghe Xing, Changlian Zhu
    Frontiers in Cellular Neuroscience.2019;[Epub]     CrossRef
  • The gross motor function measure is valid for Fukuyama congenital muscular dystrophy
    Takatoshi Sato, Michiru Adachi, Kaho Nakamura, Masaya Zushi, Keisuke Goto, Terumi Murakami, Kumiko Ishiguro, Minobu Shichiji, Kayoko Saito, Tetsuo Ikai, Makiko Osawa, Izumi Kondo, Satoru Nagata, Keiko Ishigaki
    Neuromuscular Disorders.2017; 27(1): 45.     CrossRef
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Prediction of Motor Recovery Using Diffusion Tensor Tractography in Supratentorial Stroke Patients With Severe Motor Involvement
Kang Hee Kim, Yun-Hee Kim, Min Su Kim, Chang-hyun Park, Ahee Lee, Won Hyuk Chang
Ann Rehabil Med 2015;39(4):570-576.   Published online August 25, 2015
DOI: https://doi.org/10.5535/arm.2015.39.4.570
Objective

To investigate whether early stage diffusion tensor tractography (DTT) values predict motor function at 3 months after onset in supratentorial stroke patients with severe motor involvement.

Methods

A retrospective study design was used to analyze medical records and neuroimaging data of 49 supratentorial stroke patients with severe motor involvement. Diffusion tensor imaging was assessed within 3 weeks after stroke in all patients. Three-dimensional tractography of the ipsilateral corticospinal tract (CST) was performed using the fiber assignment of the continuous tracking algorithm. The two-step DTT analysis was used. The first step was classification according to ipsilateral CST visualization. The second step was a quantitative analysis of the visible-CST group parameters. Motor function was assessed at 2 weeks and at 3 months after stroke. Comparative and correlation analyses were performed between DTT-derived measures and motor assessment scores.

Results

Motor function of the upper extremity at 3 months after stroke was significantly higher in the visible-CST group than that in the nonvisible-CST group (p<0.05). Early stage fractional anisotropy was of DTT correlated significantly with upper extremity motor function at 3 months after stroke in the visible-CST group (p<0.05).

Conclusion

These results demonstrate that early DTT-derived measures predict motor recovery in the upper extremity at 3 months after onset in supratentorial stroke patients with severe motor involvement.

Citations

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  • Mối tương quan giữa một số chỉ số trên cộng hưởng từ bó tháp trong tiên lượng khả năng phục hồi chức năng vận động ở bệnh nhân nhồi máu não vùng trên lều
    Thị Phương Lâm Trịnh, Thị Thanh Bình Nguyễn, Thị Mỹ Lê, Công Tiến Nguyễn
    Tạp chí thần kinh học Việt Nam.2024; (43): 42.     CrossRef
  • A Diffusion Tensor Imaging–Based Prognostic Classification for Surgery of Intrinsic Lesions Involving the Motor Pathways
    Giovanni Muscas, Antonio Pisano, Riccardo Carrai, Andrea Bianchi, Federico Capelli, Vita Maria Montemurro, Cristiana Martinelli, Enrico Fainardi, Antonello Grippo, Alessandro Della Puppa
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    Bokkyu Kim, Carolee Winstein
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    Wolf-Dieter Heiss
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    Won Hyuk Chang, Eunhee Park, Jungsoo Lee, Ahee Lee, Yun-Hee Kim
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    Neurology.2016; 86(20): 1924.     CrossRef
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Case Reports

Hepatic Encephalopathy With Corticospinal Tract Involvement Demonstrated by Diffusion Tensor Tractography
Hyun Bang, Hye Yeon Lee, Bo-Ram Kim, In-Sik Lee, Heeyoune Jung, Seong-Eun Koh, Jongmin Lee
Ann Rehabil Med 2015;39(1):138-141.   Published online February 28, 2015
DOI: https://doi.org/10.5535/arm.2015.39.1.138

A 50-year-old man with liver cirrhosis and esophageal varix for 3 years was diagnosed with hematemesis and treated for a bleeding varix. However, bleeding recurred 11 days later, and he developed drowsiness with left hemiparesis. His left upper and lower extremity muscle strengths based on the manual muscle test at the onset were grade 2/5 and 1/5, respectively. The Babinski sign was positive. His serum ammonia level was elevated to 129.9 µg/dL (normal, 20-80 µg/dL). Magnetic resonance imaging revealed restriction on diffusion and T2-hyperintensities with decreased apparent diffusion coefficient values in the bilateral frontoparietooccipital cortex. The effect was more severe in the right hemisphere and right parietooccipital cortices, which were compatible with hepatic encephalopathy. Although the patient's mental status recovered, significant left-sided weakness and sensory deficit persisted even after 6 months. Diffusion tensor tractography (DTT) performed 3 months post-onset showed decreased volume of the right corticospinal tract. We reported a patient with hepatic encephalopathy involving the corticospinal tract by DTT.

Citations

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  • Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using diffusion kurtosis imaging and their associations with neurocognitive dysfunction
    Qing Sun, Wenliang Fan, Yuan Liu, Zhifeng Kou, Ping Han
    Frontiers in Human Neuroscience.2025;[Epub]     CrossRef
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  • 50 Download
  • 1 Web of Science
  • 1 Crossref
Intracranial Hemorrhage in the Corpus Callosum Presenting as Callosal Disconnection Syndrome: FDG-PET and Tractography: A Case Report
In Hwan Kim, Soyoung Lee, Chang-Young Lee, Dong Gyu Lee
Ann Rehabil Med 2014;38(6):871-875.   Published online December 24, 2014
DOI: https://doi.org/10.5535/arm.2014.38.6.871

We report the findings of 18F-fluorodeoxyglocese positron emission tomography (FDG-PET) and diffusion tensor tractography (DTT) in a right-handed patient presenting with callosal disconnection syndrome, including alien hand syndrome, after an anterior communicating artery aneurysmal rupture. The 49-year-old patient had right hemiparesis and unintended movement of the right hand during action of the left hand. A brain magnetic resonance imaging revealed lesions in the upper part of the genu and body in the corpus callosum as well as hemorrhage in the inter-hemispheric fissure. We observed extensive disruption of corpus callosum fibers in the upper genu and trunk by DTT for the evaluation of inter-hemispheric connection. FDG-PET revealed severe hypometabolism in the left cerebral hemisphere, including basal ganglia and thalamus, and hypermetabolism in the right cerebral hemisphere. Based on findings of FDG-PET and DTT, the callosal disconnection syndrome presented in the patient could be the result of loss of transcallosal inhibition in the contralateral hemisphere.

Citations

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  • We Need New Thinking to Save Babies
    Akhil Maheshwari, Mario Motta, Kei Lui
    Newborn.2024; 3(2): iv.     CrossRef
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    Kang Qu, Lin Gan, Wei Jiang, Peng Yu, Ming Dong
    Frontiers in Neurology.2021;[Epub]     CrossRef
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    Tim Wende, Karl-Titus Hoffmann, Jürgen Meixensberger
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2020; 81(05): 442.     CrossRef
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    N. Khalighinejad, A. Kunnumpurath, C. Bertini, E. Ladavas, P. Haggard
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    Anhar Hassan, Keith A. Josephs
    Current Neurology and Neuroscience Reports.2016;[Epub]     CrossRef
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    Nicola A. Marchi, Radek Ptak, Corinne Wetzel, Maria I. Vargas, Armin Schnider, Nicolas Nicastro
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Medical Management for Intractable Pain Arising From Primary Sjögren Syndrome Involving Both Brain and Spinal Cord: A Case Report
Kyoung Moo Lee, Kyu Yong Han, Oh Pum Kwon
Ann Rehabil Med 2014;38(4):568-574.   Published online August 28, 2014
DOI: https://doi.org/10.5535/arm.2014.38.4.568

Primary Sjögren syndrome, which involves lesions in both the brain and spinal cord, is rarely reported. Related symptoms, such as intractable pain due to central nervous system involvement, are very rare. A 73-year-old woman diagnosed with primary Sjögren syndrome manifested with subacute encephalopathy and extensive transverse myelitis. She complained of severe whole body neuropathic pain. Magnetic resonance imaging demonstrated a non-enhancing ill-defined high intensity signal involving the posterior limb of the both internal capsule and right thalamus on a T2 fluid-attenuated inversion recovery image. Additionally, multifocal intramedullary ill-defined contrast-enhancing lesion with cord swelling from the C-spine to L-spine was also visible on the T2-weighted image. Her intractable pain remarkably improved after administration of concomitant oral doses of gabapentin, venlafaxine, and carbamazepine.

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  • Sjögren Sendromunda Nörolojik Tutulum: Olgular Temelinde Gözden Geçirme
    Miruna Florentina
    Journal of Contemporary Medicine.2018;[Epub]     CrossRef
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Original Articles

Neuroradiological and Neurophysiological Characteristics of Patients With Dyskinetic Cerebral Palsy
Byung-Hyun Park, Sung-Hee Park, Jeong-Hwan Seo, Myoung-Hwan Ko, Gyung-Ho Chung
Ann Rehabil Med 2014;38(2):189-199.   Published online April 29, 2014
DOI: https://doi.org/10.5535/arm.2014.38.2.189
Correction in: Ann Rehabil Med 2015;39(4):659
Objective

To investigate neuroradiological and neurophysiological characteristics of patients with dyskinetic cerebral palsy (CP), by using magnetic resonance imaging (MRI), voxel-based morphometry (VBM), diffusion tensor tractography (DTT), and motor evoked potential (MEP).

Methods

Twenty-three patients with dyskinetic CP (13 males, 10 females; mean age 34 years, range 16-50 years) were participated in this study. Functional evaluation was assessed by the Gross Motor Functional Classification System (GMFCS) and Barry-Albright Dystonia Scale (BADS). Brain imaging was performed on 3.0 Tesla MRI, and volume change of the grey matter was assessed using VBM. The corticospinal tract (CST) and superior longitudinal fasciculus (SLF) were analyzed by DTT. MEPs were recorded in the first dorsal interossei, the biceps brachii and the deltoid muscles.

Results

Mean BADS was 16.4±5.0 in ambulatory group (GMFCS levels I, II, and III; n=11) and 21.3±3.9 in non-ambulatory group (GMFCS levels IV and V; n=12). Twelve patients showed normal MRI findings, and eleven patients showed abnormal MRI findings (grade I, n=5; grade II, n=2; grade III, n=4). About half of patients with dyskinetic CP showed putamen and thalamus lesions on MRI. Mean BADS was 20.3±5.7 in normal MRI group and 17.5±4.0 in abnormal MRI group. VBM showed reduced volume of the hippocampus and parahippocampal gyrus. In DTT, no abnormality was observed in CST, but not in SLF. In MEPs, most patients showed normal central motor conduction time.

Conclusion

These results support that extrapyramidal tract, related with basal ganglia circuitry, may be responsible for the pathophysiology of dyskinetic CP rather than CST abnormality.

Citations

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  • Assessment tools for evaluating body structure-function and activity in dyskinetic cerebral palsy: a systematic review of instrumented assessments according to ICF-CY
    Eda Burç, Cemil Özal, Mintaze Kerem Günel
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    Ana Luísa de Almeida Marcelino, Bassam Al-Fatly, Mehmet S Tuncer, Ingeborg Krägeloh-Mann, Anne Koy, Andrea A Kühn
    Brain Communications.2025;[Epub]     CrossRef
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    Victoria D'Amours, Nafisa Husein, Mary Dunbar, Darcy Fehlings, Ram Mishaal, Michael Shevell, John Andersen, David Buckley, Adam Kirton, Louise Koclas, Maryam Oskoui, Nicole Pigeon, Ellen Wood
    Pediatric Neurology.2025; 172: 101.     CrossRef
  • Time and Mind: A State-of-the-Art Perspective on Time Perception and Cognitive–Motor Interactions in Children and Adolescents with Cerebral Palsy
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    Children.2025; 12(10): 1283.     CrossRef
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    Anna Saranti, Pinelopi Dragoumi, Antigone Papavasiliou, Dimitrios Zafeiriou
    European Journal of Paediatric Neurology.2024; 51: 49.     CrossRef
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    Xavier Caldú, Lee B. Reid, Kerstin Pannek, Jurgen Fripp, Júlia Ballester‐Plané, David Leiva, Roslyn N. Boyd, Roser Pueyo, Olga Laporta‐Hoyos
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    Evy Dhondt, Bernard Dan, Frank Plasschaert, Marc Degelaen, Charlotte Dielman, Delphine Dispa, Iulia Ebetiuc, Danielle Hasaerts, Sandra Kenis, Costanza Lombardo, Karine Pelc, Vanessa Wermenbol, Els Ortibus
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    Jakob Lorentzen, Alfred P. Born, Christian Svane, Christian Forman, Bjarne Laursen, Annika R. Langkilde, Peter Uldall, Christina E. Hoei‐Hansen
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Factors Affecting the Motor Evoked Potential Responsiveness and Parameters in Patients With Supratentorial Stroke
Tae Woong Choi, Seung Gul Jang, Seung Nam Yang, Sung-Bom Pyun
Ann Rehabil Med 2014;38(1):19-28.   Published online February 25, 2014
DOI: https://doi.org/10.5535/arm.2014.38.1.19
Objective

To investigate the factors which affect the motor evoked potential (MEP) responsiveness and parameters and to find the correlation between the function of the upper extremities and the combined study of MEP with a diffusion tensor tractography (DTT) in patients with stroke.

Methods

A retrospective study design was used by analyzing medical records and neuroimaging data of 70 stroke patients who underwent a MEP test between June 2011 and March 2013. MEP parameters which were recorded from the abductor pollicis brevis muscle were the resting motor threshold, latency, amplitude, and their ratios. Functional variables, Brunnstrom stage of hand, upper extremity subscore of Fugl-Meyer assessment, Manual Function Test, and the Korean version of Modified Barthel Index (K-MBI) were collected together with the biographical and neurological data. The DTT parameters were fiber number, fractional anisotropy value and their ratios of affected corticospinal tract. The data were compared between two groups, built up according to the presence (MEP-P) or absence (MEP-N) of MEP on the affected hand.

Results

Functional and DTT variables were significantly different between MEP-P and MEP-N groups (p<0.001). Among the MEP-P group, the amplitude ratio (unaffected/affected) was significantly correlated with the Brunnstrom stage of hand (r=-0.427, p=0.013), K-MBI (r=-0.380, p=0.029) and the time post-onset (r=-0.401, p=0.021). The functional scores were significantly better when both MEP response and DTT were present and decreased if one or both of the two studies were absent.

Conclusion

This study indicates MEP responsiveness and amplitude ratio are significantly associated with the upper extremity function and the activities of daily living performance, and the combined study of MEP and DTT provides useful information.

Citations

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  • Short-term and long-term predictors of balance function in stroke patients: a 6-month follow-up study
    Eun Young Lee, Yoonhye Na, Minjae Cho, Yu Mi Hwang, Hyun-Soo Kim, Hyonggin An, Sung-Bom Pyun
    International Journal of Rehabilitation Research.2023; 46(2): 163.     CrossRef
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    Eun Young Lee, Yoonhye Na, Minjae Cho, Yu Mi Hwang, Jun Soo Noh, Hee-Kyu Kwon, Sung-Bom Pyun
    American Journal of Physical Medicine & Rehabilitation.2022; 101(3): 203.     CrossRef
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    Isil Fazilet Turna, Belgin Erhan, Necibe Berrin Gunduz, Onder Turna
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    Yury D. Barkhatov, Albert S. Kadykov
    Annals of Clinical and Experimental Neurology.2017; 11(1): 80.     CrossRef
  • Prognostic factors for recovery of motor dysfunction following ischemic stroke
    Yury D. Barkhatov, Albert S. Kadykov
    Annals of Clinical and Experimental Neurology.2017; 11(1): 80.     CrossRef
  • Prediction of Motor Recovery Using Quantitative Parameters of Motor Evoked Potential in Patients With Stroke
    Jae Yong Jo, Ahee Lee, Min Su Kim, Eunhee Park, Won Hyuk Chang, Yong-Il Shin, Yun-Hee Kim
    Annals of Rehabilitation Medicine.2016; 40(5): 806.     CrossRef
  • Comparison of Diffusion Tensor Tractography and Motor Evoked Potentials for the Estimation of Clinical Status in Subacute Stroke
    Kwang-Soo Chun, Yong-Taek Lee, Jong-Wan Park, Joon-Youn Lee, Chul-Hyun Park, Kyung Jae Yoon
    Annals of Rehabilitation Medicine.2016; 40(1): 126.     CrossRef
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  • 59 Download
  • 6 Web of Science
  • 8 Crossref
The Insertion/Deletion Polymorphism of Angiotensin I Converting Enzyme Gene is Associated With Ossification of the Posterior Longitudinal Ligament in the Korean Population
Dong Hwan Kim, Dong Hwan Yun, Hee-Sang Kim, Seong Ki Min, Seung Don Yoo, Kyu Hoon Lee, Ki-Tack Kim, Dae Jean Jo, Su Kang Kim, Joo-Ho Chung, Ju Yeon Ban, Sung Yong Lee
Ann Rehabil Med 2014;38(1):1-5.   Published online February 25, 2014
DOI: https://doi.org/10.5535/arm.2014.38.1.1
Objective

To determine whether ACE insertion/deletion (I/D) polymorphism is associated with the ossification of the posterior longitudinal ligament (OPLL) of the spine in the Korean population.

Methods

A case-control study was conducted to investigate the association between I/D polymorphism of the angiotensin I converting enzyme (peptidyl-dipeptidase A) 1 (ACE) gene and OPLL. The 95 OPLL patients and 274 control subjects were recruited. Polymerase chain reaction for the genotyping of ACE I/D polymorphism was performed. The difference between the OPLL patients and the control subjects was compared using the contingency χ2 test and the logistic regression analysis. For statistical analysis, SPSS, SNPStats, SNPAnalyzer, and Helixtree programs were used.

Results

The genotype and allele frequencies of ACE I/D polymorphism showed significant differences between the OPLL patients and the control subjects (genotype, p<0.001; allele, p=0.009). The frequencies of D/D genotype and D allele in the OPLL group were higher than those in the control group. In logistic regression analysis, ACE I/D polymorphism was associated with OPLL (dominant model; p=0.002; odd ratio, 2.20; 95% confidence interval, 1.33-3.65).

Conclusion

These results suggest that the deletion polymorphism of the ACE gene may be a risk factor for the development of OPLL in the Korean population.

Citations

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  • Evaluation of Genetic and Nongenetic Risk Factors for Degenerative Cervical Myelopathy
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  • Genetics of Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis of Candidate Gene Studies
    Daniel H. Pope, Benjamin M. Davies, Oliver D. Mowforth, A. Ramsay Bowden, Mark R. N. Kotter
    Journal of Clinical Medicine.2020; 9(1): 282.     CrossRef
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Case Reports

Corticospinal Tract and Pontocerebellar Fiber of Central Pontine Myelinolysis
Yong Min, Sung-Hee Park, Seung-Bae Hwang
Ann Rehabil Med 2012;36(6):887-892.   Published online December 28, 2012
DOI: https://doi.org/10.5535/arm.2012.36.6.887

Central pontine myelinolysis is a rare neurologic disorder that is defined by demyelination of longitudinally descending tracts and transversly crossing fibers in the basis pontis. Frequently observed clinical manifestations of this disorder include sudden weakness, dysphagia, loss of consciouness and locked-in syndrome. However, there have been a few studies that reported a benign course of this disease, which include cerebellar signs, such as ataxia, intention tremor, and dysarthria. Here we report on a 53-year-old male with a history of liver cirrhosis who showed the cerebellar type of central pontine myelinolysis. The patient was diagnosed with central pontine myelinolysis based on clinical presentations and magnetic resonance imaging findings after a liver transplantation. Conventional magenetic resonance imaging (MRI) revealed the preservation of the corticospinal tract and abnormal pontocerebellar fibers. However, these findings were not sufficient to define the pathophysiology of our patient. Electrophysiologic analysis and diffusion tensor imaging (DTI) were performed to investigate cerebellar signs in this case. Delayed central motor conduction time (CMCT) to the tibialis anterior muscle with transcranial magnetic stimulation (TMS) was observed, which indicated demyelination of the corticospinal tract. Also, diffusion tensor imaging showed abnormal pontocerebellar fibers, which might have been caused by cerebellar dysfunction in our patient. A combination of TMS and DTI was also used to determine the pathophysiology of this disease.

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  • Locked‐in syndrome after central pontine myelinolysis, an outstanding outcome of two patients
    Maïlys Chabert, Corentin Dauleac, Maude Beaudoin‐Gobert, Mélaine De‐Quelen, Sophie Ciancia, Timothée Jacquesson, Simon Bertrand, Emmanuel Vivier, Donatien De‐Marignan, Julien Jung, Nathalie Andre‐Obadia, Florent Gobert, François Cotton, Jacques Luauté
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    Frontiers in Human Neuroscience.2020;[Epub]     CrossRef
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    Min Cheol Chang, Jeong Pyo Seo
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    Sung Ho Jang, Hyeok Gyu Kwon
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    Walid I. Essayed, Harminder Singh, Gennaro Lapadula, Gustavo J. Almodovar-Mercado, Vijay K. Anand, Theodore H. Schwartz
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    Johannes Goldberg, Moritz Daniel, Yasemin van Heuvel, Marion Victor, Cordian Beyer, Tim Clarner, Markus Kipp
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Fornix Injury in a Patient with Rotavirus Encephalopathy: Diffusion Tensor Tractography Study
Su Min Son, Sung Ho Jang, Eun Sil Lee, Sang Ho Ahn, Dong Gyu Lee, Hee Kyung Cho
Ann Rehabil Med 2012;36(4):551-555.   Published online August 27, 2012
DOI: https://doi.org/10.5535/arm.2012.36.4.551

Rotavirus encephalopathy (RE) is a benign afebrile seizure associated with acute gastroenteritis caused by rotavirus infection. We investigated the diffusion tensor tractography (DTT) findings of a patient with RE. The patient was a 30-month-old female that had experienced a brief, generalized convulsive seizure. On the day of admission, the patient had vomiting and experienced watery diarrhea. Her stool was positive for rotavirus antigen. At onset, the patient displayed a drowsy and delirious mental status; later, a splenial lesion of the corpus callosum was found on MRI. One week later, the patient's condition improved and the splenial lesion had disappeared by conventional MRI. Initial DTI showed decreased fractional anisotropy (FA) values of fornix, as well as of the corpus callosum. A follow-up DTT showed a restored interrupted right fonical crus and increased FA values of corpus callosum and fornix. These results highlight the implications of the probability of not only a corpus callosum injury, but a fornix injury as well, in this patient with RE.

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  • Neurological complications of rotavirus infection in children: A systematic review and meta‐analysis
    A. Meyer, C. Mazzara, S. A. G. Lava, G. Treglia, M. G. Bianchetti, B. Goeggel Simonetti, G. D. Simonetti
    Acta Paediatrica.2023; 112(7): 1565.     CrossRef
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    Young Jae Choi, Eun Ja Lee, Jung Eun Lee
    Investigative Magnetic Resonance Imaging.2021; 25(2): 59.     CrossRef
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    Christopher G. Filippi, Keith A. Cauley
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  • 3 Crossref

Original Article

The Impacts of ACE Activity according to ACE I/D Polymorphisms on Muscular Functions of People Aged 65
Hyeon-Jung Kang, Chul-Hyun Kim, Dong-Sik Park, Seung-Yeon Choi, Dong-Hoon Lee, Hee-Seung Nam, Jin-Gang Hur, Ji-Hea Woo
Ann Rehabil Med 2012;36(4):433-446.   Published online August 27, 2012
DOI: https://doi.org/10.5535/arm.2012.36.4.433
Objective

To investigate associations between angiotensin-converting enzyme (ACE) polymorphisms and muscle fatigability in 65-year-old Koreans.

Method

The study participants were 49 Koreans aged 65 years. ACE insertion/deletion (I/D) polymorphisms were determined by polymerase chain reaction and serum ACE activity, by spectrophotometry. Body mass index (BMI), body fat mass (BFM), and lean body mass (LBM) were determined. To evaluate muscle fatigability, dynamic Electromyography was used to measure maximum voluntary isometric contractions (MVICs) of ankle plantar flexor muscles. Patients were seated with their hips flexed at 90°, knees fully extended, and ankles at 0°. Continuous submaximal VICs (40% MVIC) were then performed, and contraction duration and EMG frequency changes during the initial 2 min were measured. A self-reported physical activity questionnaire was used to evaluate effects of ACE activity levels on muscle fatigability.

Results

Among the 49 volunteers, 15 showed II genotype; 22, ID genotype; and 12, DD genotype. Serum ACE activity levels were significantly higher in DD genotype subjects than in II genotype subjects (p<0.05). Furthermore, the duration of submaximal isometric contractions was longer in II and ID genotype subjects than in DD genotype subjects (p<0.05). Dynamic EMG showed significantly lower mean frequency changes in II genotype subjects than in DD genotype subjects (p<0.05). However, LBM, BFM, and BMI were independent of ACE genotypes.

Conclusion

ACE II genotype subjects showed significantly higher resistant to muscle fatigue than that by DD genotype subjects. However, body composition and BMI showed no correlations with ACE I/D polymorphisms.

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  • ACE I/D Genotype and Risk of Non-Contact Injury in Moroccan Elite Athletes: A Pilot Study
    El Mokhtar El Ouali, Jihan Kartibou, Juan Del Coso, Rashmi Supriya, Ismail Laher, Zineb El Kettani, Hassan Ghazal, Najib Al Idrissi, Ayoub Saeidi, Abdelhalem Mesfioui, Hassane Zouhal
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    Severino Leão de Albuquerque-Neto, Marcos Antonio Pereira dos Santos, Valmir Oliveira Silvino, Jose Juan Blanco Herrera, Thiago Santos Rosa, Glauber Castelo Branco Silva, Bruno Pena Couto, Cirley Pinheiro Ferreira, Alexandre Sérgio Silva, Sandro Soares de
    BMC Sports Science, Medicine and Rehabilitation.2024;[Epub]     CrossRef
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    Myosotis Massidda, Laura Flore, Paolo Cugia, Francesco Piras, Marco Scorcu, Naoki Kikuchi, Pawel Cięszczyk, Agnieszka Maciejewska-Skrendo, Filippo Tocco, Carla Maria Calò
    Sports Medicine - Open.2024;[Epub]     CrossRef
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    Martin Flück, Paola Valdivieso, Marie-Noëlle Giraud, Barry Kim Humphreys
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    Benedikt Gasser, Walter O. Frey, Paola Valdivieso, Johannes Scherr, Jörg Spörri, Martin Flück
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    Christos Rossios, Tufail Bashir, Marcus Achison, Simon Adamson, Asangaedem Akpan, Terry Aspray, Alison Avenell, Margaret M. Band, Louise A. Burton, Vera Cvoro, Peter T. Donnan, Gordon W. Duncan, Jacob George, Adam L. Gordon, Celia L. Gregson, Adrian Hapca
    PLOS ONE.2023; 18(10): e0292402.     CrossRef
  • High serum angiotensin-converting enzyme 2 activity as a biomarker of frailty in nursing home residents
    Begoña Sanz, Chloe Rezola-Pardo, Haritz Arrieta, Ainhoa Fernández-Atutxa, Inmaculada Lora-Diaz, Javier Gil-Goikouria, Ana Rodriguez-Larrad, Jon Irazusta
    Experimental Gerontology.2022; 158: 111655.     CrossRef
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    Joanna Kostka, Joanna Sikora, Agnieszka Guligowska, Tomasz Kostka
    F1000Research.2021; 10: 184.     CrossRef
  • Quadriceps muscle power and optimal shortening velocity are inversely related to angiotensin converting enzyme activity in older men
    Joanna Kostka, Joanna Sikora, Agnieszka Guligowska, Tomasz Kostka
    F1000Research.2021; 10: 184.     CrossRef
  • Association between the ACE I/D polymorphism and muscle injuries in Italian and Japanese elite football players
    Myosotis Massidda, Eri Miyamoto-Mikami, Hiroshi Kumagai, Hayato Ikeda, Yu Shimasaki, Masafumi Yoshimura, Paolo Cugia, Francesco Piras, Marco Scorcu, Naoki Kikuchi, Carla Maria Calò, Noriyuki Fuku
    Journal of Sports Sciences.2020; 38(21): 2423.     CrossRef
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Case Report

Amyotrophic Lateral Sclerosis with an Acute Hypertensive Crises
Ha Lim Lee, Ju Kang Lee
Ann Rehabil Med 2012;36(3):418-422.   Published online June 30, 2012
DOI: https://doi.org/10.5535/arm.2012.36.3.418

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder involving the systemic motor neurons, but autonomic nervous function is relatively well preserved. A few studies related to autonomic dysfunction have been reported, but autonomic dysfunction is rare in ALS. Moreover, dysautonomia symptoms are not prominent in patients with ALS. We present a 55-year-old male patient with ALS, who had acute severe hypertension and tachycardia crises, as well as sudden falls in his blood pressure. After he was diagnosed with ALS, he suddenly collapsed and was placed under mechanical ventilation. Several hypertensive attacks and dysautonomic signs then occurred. We successfully controlled the dysautonomia using diazepam and doxazocin mesylate, an alpha receptor antagonist.

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    Sungmin Park, Daeun Kim, Jaeseung Song, Jong Wha J. Joo
    International Journal of Molecular Sciences.2021; 22(6): 3216.     CrossRef
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    Yuval Nash, Michal Sitty
    Journal of Neuromuscular Diseases.2021; 8(4): 699.     CrossRef
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    Charlotte A. Kelley, Sasha De Henau, Liam Bell, Tobias B. Dansen, Erin J. Cram, Jeffrey Hardin
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    Yuki Nakayama, Toshio Shimizu, Chiharu Matsuda, Michiko Haraguchi, Kentaro Hayashi, Yoko Mochizuki, Masahiro Nagao, Akihiro Kawata, Eiji Isozaki
    Muscle & Nerve.2018; 57(5): 735.     CrossRef
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    Katsunori Yokoi, Tetsuo Ando, Sawao Ishikawa
    Rinsho Shinkeigaku.2017; 57(12): 782.     CrossRef
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    Grant Coan, Cassie S. Mitchell
    Neurodegenerative Diseases.2015; 15(5): 301.     CrossRef
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    Bart Swinnen, Wim Robberecht
    Nature Reviews Neurology.2014; 10(11): 661.     CrossRef
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Original Articles

Comparison of Sono-guided Capsular Distension with Fluoroscopically Capsular Distension in Adhesive Capsulitis of Shoulder
Ki Deok Park, Hee Seung Nam, Tai Kon Kim, Seong Hoon Kang, Min Ho Lim, Yongbum Park
Ann Rehabil Med 2012;36(1):88-97.   Published online February 29, 2012
DOI: https://doi.org/10.5535/arm.2012.36.1.88
Objective

To investigate the short-term effects and advantages of sono-guided capsular distension, compared with fluoroscopically guided capsular distension in adhesive capsulitis of shoulder.

Method

In this prospective, randomized, and controlled trial, 23 patients (group A) were given an intra-articular injection of a mixture of 0.5% lidocaine (9 ml), contrast dye (10 ml), and triamcinolone (20 mg); they received the injection once every 2 weeks, for a total of 6 weeks, under sono-guidance. Twenty-five patients (group B) were treated similarly, under fluoroscopic guidance. Instructions for the self-exercise program were given to all subjects, without physiotherapy and medication. Effects were then assessed using a visual numeric scale (VNS), and the shoulder pain and disability index (SPADI), as well as a range of shoulder motion examinations which took place at the beginning of the study and 2 and 6 weeks after the last injection. Incremental cost-effective ratio (ICER), effectiveness, preference, and procedure duration were evaluated 6 weeks post-injection.

Results

The VNS, SPADI, and shoulder motion range improved 2 weeks after the last injection and continued to improve until 6 weeks, in both groups. However, no statistical differences in changes of VNS, SPADI, ROM, and effectiveness were found between these groups. Patients preferred sono-guided capsular distension to fluoroscopically guided capsular distension due to differences in radiation hazards and positional convenience. Procedure time was shorter for sono-guided capsular distension than for fluoroscopically guided capsular distension.

Conclusion

Sono-guided capsular distension has comparable effects with fluoroscopically guided capsular distension for treatment of adhesive capsulitis of the shoulder. Sono-guided capsular distension can be substituted for fluoroscopic capsular distension and can be advantageous from the viewpoint of radiation hazard mitigation, time, cost-effectiveness and convenience.

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  • Research Progress on Ultrasound-Guided Acupotomy Combined with Hydrodilatation for Adhesive Capsulitis of Shoulder
    澳华 马
    Advances in Clinical Medicine.2025; 15(07): 965.     CrossRef
  • Corticosteroid Injection Methods for Frozen Shoulder: A Network Meta-analysis
    Chun-Wei Liang, Hsiao-Yi Cheng, Yu-Hao Lee, Chun- De Liao, Shih-Wei Huang
    Archives of Physical Medicine and Rehabilitation.2024; 105(4): 750.     CrossRef
  • Ultrasound-Guided Infiltrative Treatment Associated with Early Rehabilitation in Adhesive Capsulitis Developed in Post-COVID-19 Syndrome
    Danilo Donati, Fabio Vita, Roberto Tedeschi, Stefano Galletti, Alessandro Biglia, Tommaso Gistri, Pasquale Arcuri, Flavio Origlio, Francesco Castagnini, Cesare Faldini, Davide Pederiva, Maria Grazia Benedetti
    Medicina.2023; 59(7): 1211.     CrossRef
  • Efficacy of hydrodilatation in frozen shoulder: a systematic review and meta-analysis
    Daryl Poku, Rifat Hassan, Filippo Migliorini, Nicola Maffulli
    British Medical Bulletin.2023; 147(1): 121.     CrossRef
  • Hydrodilatation versus corticosteroid injection in treatment for adhesive capsulitis
    Erek Latzka, Malia Cali, Haruki Ishii, Salvador Portugal, Jennifer Soo Hoo
    PM&R.2023; 15(12): 1580.     CrossRef
  • Usefulness of combined handheld ultrasound and fluoroscopy-guided injection in adhesive capsulitis of the shoulder: A prospective, randomized single blind-pilot study
    Ki Deok Park, Jeong Won Ryu, Kyoung Rai Cho, Yongbum Park, Wook-Jin Chung
    Journal of Back and Musculoskeletal Rehabilitation.2022; 35(4): 901.     CrossRef
  • Ultrasound-Guided Suprascapular Nerve Block at Spinoglenoid Notch and Glenohumeral Joint Hydrodilation
    Renaldi Prasetia, Rifki Albana, Herry Herman, Ronny Lesmana, Bancha Chernchujit, Hermawan Nagar Rasyid
    Arthroscopy Techniques.2022; 11(7): e1233.     CrossRef
  • Intra-articular distension preceded by physical therapy versus intra-articular distension followed by physical therapy for treating adhesive capsulitis of the shoulder
    Anis Jellad, Wafa May, Ahmed Zrig, Amine Kalai, Mahbouba Jguirim, Zohra Ben Salah Frih, Mondher Golli
    Journal of Back and Musculoskeletal Rehabilitation.2020; 33(3): 443.     CrossRef
  • In shoulder adhesive capsulitis, ultrasound-guided anterior hydrodilatation in rotator interval is more effective than posterior approach: a randomized controlled study
    Basant Elnady, Elsayed M. Rageh, Manal Shawky Hussein, Mohammed Hassan Abu-Zaid, Dalia El-Sayed Desouky, Tohamy Ekhouly, Johannes J. Rasker
    Clinical Rheumatology.2020; 39(12): 3805.     CrossRef
  • Comparative Efficacy of Intra-Articular Steroid Injection and Distension in Patients With Frozen Shoulder: A Systematic Review and Network Meta-Analysis
    Meng-Ting Lin, Ming-Yen Hsiao, Yu-Kang Tu, Tyng-Guey Wang
    Archives of Physical Medicine and Rehabilitation.2018; 99(7): 1383.     CrossRef
  • Effectiveness of Glenohumeral Joint Dilatation for Treatment of Frozen Shoulder: A Systematic Review and Meta-analysis of Randomized Controlled Trials
    Wei-Ting Wu, Ke-Vin Chang, Der-Sheng Han, Chung-Hsun Chang, Fu-Sui Yang, Chih-Peng Lin
    Scientific Reports.2017;[Epub]     CrossRef
  • Correlations between MRI findings and outcome of capsular distension in adhesive capsulitis of the shoulder
    Yun Hee Park, Young Sook Park, Hyun Jung Chang, Yeongmi Kim
    Journal of Physical Therapy Science.2016; 28(10): 2798.     CrossRef
  • Usefulness of a Hanging Position With Internal Rotation of Shoulder in Ultrasonography-Guided Intra-articular Steroid Injection for Adhesive Capsulitis
    Chang Han Lee, Hyung Seok Nam, Shi-Uk Lee
    Annals of Rehabilitation Medicine.2016; 40(3): 520.     CrossRef
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    Juan Pons‐Villanueva, Javier Escalada San Martín
    International Journal of Rheumatic Diseases.2016; 19(12): 1226.     CrossRef
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    Young Sook Park, Yun Hee Park
    Journal of the Korean Geriatrics Society.2015; 19(3): 147.     CrossRef
  • Randomized Controlled Trial for Efficacy of Capsular Distension for Adhesive Capsulitis: Fluoroscopy-Guided Anterior Versus Ultrasonography-Guided Posterolateral Approach
    Jae Hyun Bae, Young Sook Park, Hyun Jung Chang, Min Jung Kim, Kang Young Park, Seung Hwan Jin, Eun Hee Lee
    Annals of Rehabilitation Medicine.2014; 38(3): 360.     CrossRef
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Reference Data of Cervical Dermatomal Somatosensory Evoked Potentials Using Low Intensity Stimulation and Report of 2 Cases.
Seo, Min Ho , Park, Sung Hee , Ko, Myoung Hwan , Eun, Jong Pil , Seo, Jeong Hwan
J Korean Acad Rehabil Med 2011;35(2):236-242.
Objective
To establish reference data for dermatomal somatosensory evoked potentials (DSEP) using a stimulation intensity lower than what is conventionally utilized. Method Fifty subjects (25 older adults>48 years old; 25 younger adults<32 years old) without history of neck pain or cervical spine surgery were enrolled. The DSEP study was performed with stimulation intensities of 1.0, 1.5, and 2.5 times sensory threshold (ST) on right arms for C5, C6, C7, and C8 dermatomes. Results The mean latencies of DSEP stimulating C5, C6, C7, and C8 dermatomes with 1.5 times ST intensity were 17.6±1.7 ms, 22.2±2.1 ms, 22.8±1.4 ms, and 22.6±1.8 ms, respectively. The mean amplitude (N1P1) of DSEP stimulating C5, C6, C7, and C8 dermatomes with 1.5 times ST intensity were 0.9±0.4 ՌV, 0.9±0.5 ՌV, 1.0±0.6 ՌV, and 1.1±0.8 ՌV, respectively. The C5, C6, C7, and C8 DSEP were evoked in 84%, 98%, 100%, and 96% of cases with 2.5 times ST compared to 64%, 56%, 60%, and 62% with 1.5 times ST, respectively. When one DSEP was not evoked, the DSEP of the opposite side was evoked only in 2 subjects. Conclusion This study provides the reference data of DSEP with lower stimulation intensities than are conventionally utilized. Additionally, two cases of clinical significance were reported.
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Validity of Two Kinds of Physical Activity Tracker for Measuring Total Calorie Expenditures and Activities above Moderate Intensity.
Choi, Eun Hi , Jun, Ah Young , Kang, Seok Won , Lee, Ju Youn , Kim, Keon Koo , Hong, Kyung Soon
J Korean Acad Rehabil Med 2010;34(6):758-766.
Objective To evaluate the validity of two kinds of physical activity trackers (PAT) during treadmill exercise.

Method 14 healthy people performed cardiopulmonary exercise test by means of Bruce protocol. The omnidirectional PATs were placed onto the right wrist and ankle, and the temperature sensing PATs were placed onto the right arm and lower leg. Simultaneous measurement of body motion was continuously recorded during cardiopulmonary exercise test. Then we checked total calorie expenditure and duration above moderated intensity activity (>3 METs) from each PATs and gas analyzer.

Results Total calorie expenditures of PAT were significantly underestimated than gas analyzer, except the temperature sensing PAT applied onto the leg, but all of them showed significant correlation. The duration above moderate intensity activity of the PAT did not show significant difference comparing with gas analyzer, except the omnidirectional PAT applied onto the arm, but all of them showed significant correlation.

Conclusion Both omnidirectional PATs and temperature sensing PATs could estimate the total calorie expenditure and the duration above moderate intensity activity. But it is necessary to apply exercise-specific protocol to PAT to enhance the accuracy of estimating energy expenditure during periods of exercise.

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Does Injured Corticospinal Tract Recover after Rehabilitation Therapy in Patients with Hemiplegic Cerebral Palsy?.
Son, Su Min , Kwak, So Young , Jang, Sung Ho , Ahn, Sang Ho , Cho, Yon Yoo , Kim, Han Seon , Cho, Hee Kyung , Moon, Han Ku
J Korean Acad Rehabil Med 2010;34(1):79-84.
Objective
To investigate whether injured corticospinal tract (CST) could recover after rehabilitative therapy in hemiplegic patients with cerebral palsy using diffusion tensor tractography (DTT) which is known to be useful in detecting microscopic white matter lesion in vivo. Method: Sixteen hemiplegic patients (mean age, 13.6 months) were enrolled. Diffuse tensor image (DTI) and gross motor functional measurement (GMFM) evaluation were performed before rehabilitative therapy and at follow-up. We measured the fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of CST in the affected and unaffected hemisphere. To evaluate asymmetry of affected and unaffected CST, asymmetry index of fractional anisotropy (AA) and asymmetry index of apparent diffusion coefficient (AD) were measured. Results: The FA value of the affected CST was lower than that of the unaffected CST and the ADC value was higher than that of the unaffected CST in initial and follow up DTT (p<0.001). Compared with the result of initial DTT, the results of follow up DTT demonstrated that the FA value of both CST was increased (p=0.000). A significant increase in AA was showed in all patients (p=0.000) and the increase of AA had significant correlation with the increase of FA of affected CST, but not with the unaffected CST (r=0.537, p=0.032). Conclusion: DTT would be a powerful modality not only for diagnosis and prognosis of cerebral palsy, but also assessment of microstructural change of CST after rehabilitative therapy. (J Korean Acad Rehab Med 2010; 34: 79-84)
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Transcallosal Fibers from Corticospinal Tract in Patients with Cerebral Hemorrage.
Kim, Wook Ro , Chang, Min Cheol , Park, Kyung A , Kwak, So Young , Do, Sung Jin , Jang, Sung Ho , Ahn, Sang Ho , Son, Su Min
J Korean Acad Rehabil Med 2009;33(6):657-663.
Objective
To investigate the relationship between the transcallosal fibers (TCFs) from the corticospinal tract (CST) and the motor function of the affected extremities in patients with cerebral hemorrhage, using diffusion tensor image tractography (DTT). Method: 49 patients with cerebral hemorrhage and 38 controls were recruited. DTT was performed using 1.5 T magnetic resonance imaging. The DTT findings were classified into 3 groups according to targeting location: no TCF from the CST (type A), TCF ended in the corpus callosum or connected to the cortex of the opposite hemisphere (type B), and TCF that descending toward the lesion after passing through the corpus callosum (type C). Results: The TCF originated from the CST of the unaffected hemisphere, and the presence of fiber descending toward the lesion after passing through the corpus callosum were significantly more prevalent in the patients who showed the worse motor function. Conclusion: The TCF originated from the unaffected CST toward the lesion in patients with cerebral hemorrhage might play a relevant role in compensating motor deficits in the major corticospinal disruption. (J Korean Acad Rehab Med 2009; 33: 657-663)
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Biomechanical Evaluation of the Capsular Stiffness and Clinical Features in Adhesive Capsulitis of Shoulders.
Kim, Keewon , Kim, Tae Uk , Leigh, Ja Ho , Lee, Kyu Jin , Kim, Hee Chan , Chung, Sun Gun
J Korean Acad Rehabil Med 2009;33(2):205-214.
Objective
To evaluate the capsular stiffness of the gleno-humeral joint by measuring the slope of pressure- volume curves generated during intra-articular hydraulic distension (IHD) and analyze its correlation with clinical variables and outcomes in terms of limitation of range of motion (LOM) and severity of pain. Method: IHD with real-time intra-articular pressure mo-nitoring was performed for 53 patients with adhesive capsulitis and the capsular stiffness was measured from pressure-volume curves by calculating the slope of elastic deformation region. LOM, measured by LOM score and sum of ROMs (range of motion), and degree of pain, measured by visual analog scale (VAS), were evaluated before and after IHD: three days (3D) and one month (1M) after IHD. Results: In patients with stiffer capsules, LOM and pain were severe before IHD (Pearson's correlation coefficient (r)= 0.291, -0.348, 0.381 and p=0.065, 0.026, 0.014 for LOM score, sum of ROMs and VAS, respectively. By this order, henceforth). On 3D follow up, the correlation between the stiffness and LOM or pain was maintained (r=0.291, -0.348, 0.381 and p=0.065, 0.026, 0.014). The improvement of LOM score on 3D follow up was less as the capsules were stiffer (r=-0.368, p=0.023). On 1M follow up, LOM remained severer in stiffer capsules whereas pain did not (r=0.372, -0.402, 0.183 and p=0.039, 0.025, 0.342). Conclusion: The stiffness of the glenohumeral joint capsule, measured from the slope of pressure-volume curves during IHD, showed significant correlation with the severity of LOM and pain in patients with adhesive capsulitis of shoulder. (J Korean Acad Rehab Med 2009; 33: 205-214)
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The Effects of Transcutaneous Electrical Nerve Stimulation for Standing Balance in Patients with Hemiplegia.
Kim, Sang Hyun , Seok, Hyun , Lee, Hyuck , Lee, Hyuk Jin , Suh, Jung Woo
J Korean Acad Rehabil Med 2009;33(2):159-164.
Objective
To evaluate the effects of transcutaneous elec-trical nerve stimulation (TENS) applied at lower extre-mity for standing balance in patients with hemiplegia. Method: Twenty-two hemiplegic patients were tested while standing on balance trainer under eight stimulation modes (No TENS, bilateral TENS, hemiplegic TENS, and una-ffected TENS. These four conditions were applied both with and without vision). All patients were able to stand inde-pendently more than five minutes. TENS was applied with pulse width 200µs, frequency of 100 Hz, amplitude set at the sensory detection threshold of each patients. TENS was applied thirty seconds for each stimulation modes, and res-ting period was 10 minutes. Postural sway was determined during the testing period by the sum of anterior-posterior (AP) center of pressure (COP) sway, medio-lateral (ML) COP sway, and total sum of COP sway. Also postural sway was determined by proportion of time of COP in three circles, which semidiameters are 10 mm, 20 mm, 30 mm each. Results: When patients were applied with TENS eyes closed at the unaffected lower extremity, AP, ML, and total sum of COP sway decreased significantly. Conclusion: In hemiplegic patients with independent standing, TENS application at the unaffected leg over five minutes can be helpful standing balance enhancement. (J Korean Acad Rehab Med 2009; 33: 159-164)
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Objective
To evaluate the outcomes of intensive conservative treatment on extraforaminal lumbar disc herniations. Method: Twenty five patients with extraforaminal lumbar disc herniations with symptomatic radicular pain were included. Under fluoroscopic guidance, 40 mg of triamcinolone was infused around the nerve root after provocation of patient's usual radicular pain. Lumbosacral dynamic stabilization exercise, thermal and electrical therapy, and education of posture correction were added. The clinical outcomes were measured by visual analogue scale (VAS) and Oswestry disability index (ODI) before treatment, one, three, six, and twelve months after the treatment. After twelve months, patients' satisfaction was classified to four categories: excellent, good, fair, or poor. Four patients were dropped out. Results: Follow-up VAS and ODI significantly decreased since post-treatment one month (p<0.0001). The average score of VAS for lower extremity and back pain reduced significantly from 6.6, 4.5 at pretreatment to 1.5, 1.9 at 12 months post-treatment, respectively (p<0.0001). The averages of ODI reduced significantly from 65.4% at pretreatment to 25.4% at post-treatment 12 months (p<0.0001). In patients' satisfaction, seventeen patients (81.0%) were recorded as excellent or good after post-treatment 12 months. Conclusion: Intensive conservative treatment was effective on patients who underwent extraforaminal lumbar disc herniation. Pain relief and functional improvement sustained for 12 months. (J Korean Acad Rehab Med 2009; 33: 89-93)
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Case Report

Persistent Autonomic Dysfunction in Guillain-Barre Syndrome: A case report.
Lee, Sang Jee , Choi, Eun Suk , Jung, Sung Hee , Cho, Ye Rim , Han, Zee A , Yu, In Hee
J Korean Acad Rehabil Med 2008;32(5):586-590.
Autonomic dysfunction is a common manifestation in Guillain-Barre syndrome (GBS), but it rarely persists. We report a case involving a 22-year-old man who presented with glove-and-stocking type sensory loss, symmetric weakness, urinary distension, orthostatic hypotension, decreased perspiration, and the syndrome of inappropriate secretion of antidiuretic hormone. He was subsequently diagnosed as having GBS with autonomic failure that persisted for more than six months, despite regaining muscle strength. Orthostatic hypotension progressively improved after rehabilitation and administration of midodrine and fludrocortisone. Extensive evaluation and management should be performed in patients with GBS because severe autonomic dysfunction is a major source of disability. (J Korean Acad Rehab Med 2008; 32: 586-590)
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Original Articles

Comparisons of Spinal Stabilization Exercise and Lumbar Extensor Strengthening Exercise in Chronic Low Back Pain.
Yi, Taeim , Lee, Jae Hwan , Lee, Young Jung , Kim, Joo Sup , Park, Jun Sung , Kim, Dae Hwan , Koo, Hye Kyung
J Korean Acad Rehabil Med 2008;32(5):570-575.
Objective: To compare the effects of spinal stabilization exercise against with lumbar extensor strengthening exercise. Method: Sixty patients with chronic low back pain were enrolled into the study and randomly classified into three groups. Groups were treated with spinal stabilization exercise (Group 1), lumbar extensor strengthening exercise using a MedX machine (Group 2), or with a combination program (Group 3) for 8 weeks. Patients were not given any other treatment modalities. Isometric peak torque of the lumbar extensors, pain rating score (PRS), Medical Outcomes Study Short Form-36 (SF-36) score, and the Oswestry low back pain disability questionnaire (OLBPD-Q) were assessed at 0, 4, and 8 weeks of exercise. Results: 1) After 8 weeks, all groups showed incremental improvements in maximal isometric torque of the lumbar extensors and exhibited improvement in SF-36, PRS, and OLBD-Q scores (p<0.05). 2) There were no significant differences in the degree of improvement among the three groups after 8 weeks of exercise. 3) The percentage of patients with scores of good or excellent in Group 3 was higher than in Groups 1 and 2 according to all evaluation tools. Conclusion: In the treatment of chronic low back pain, all exercise groups showed decreased pain, improved quality of life, and increased lumbar extensor strength regardless of the exercise type employed. We suggest that exercise programs in general are effective for the treatment of chronic low back pain and a combination exercise program seems to be most beneficial. (J Korean Acad Rehab Med 2008; 32: 570-575)
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Factors Inhibiting Recovery of Orthostatic Hypotension with Ischemic Stroke Patients.
Jeong, Ho Joong , Kim, Ghi Chan , Sim, Young Joo , Eom, Moon Sub , Hong, Jin Young , Lee, Jong Hwa
J Korean Acad Rehabil Med 2008;32(3):289-293.
Objective
To determine the time period and factors inhibiting recovery of orthostatic hypotension during head up tilt with ischemic stroke patients.Method: Fourty two ischemic stroke patients with orthostatic hypotension were included. Blood pressure and heart rate were taken after resting in the supine position for 10 minutes and again after standing for one minute every week. Age, gender, body mass index, laboratory findings, diabetes mellitus, anti-hypertensive use, side of involved hemisphere and K-MBI were obtained.Results: The numbers of orthostatic hypotension patients were significantly decreased at 3rd week. Non recovering group until 3rd week were older in age and had higher plasma creatinine level. On the other hand, body mass index and K-MBI were lower than the group without orthostatic hypotention. Multivariate analysis revealed that age, body mass index, anti-hypertensive medication were independently associated factors for resistant orthostatic hypotension during head up tilt.Conclusion: For 7 weeks, especially at 3rd week, the numbers of orthostatic hypotension patients significantly decreased. Age, BMI, and antihypertensive medication were inhibitiing factors for recovery of orthostatic hypotension. (J Korean Acad Rehab Med 2008; 32: 289-293)
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Case Report

Clinical Usefulness of Diffusion Tensor Image Tractography in Stroke Patients: Report of two cases.
Kang, Jae Hoon , Park, Kyung A , Yang, Dong Seok , Jang, Sung Ho , Ahn, Sang Ho , Cho, Yun Woo , Kim, Dong Gyu
J Korean Acad Rehabil Med 2008;32(2):222-225.
We report the clinical usefulness of elucidating the state of the corticospinal tract (CST) by the use of diffusion tensor image tractography (DTT) in hemiparetic stroke patients. DTT was performed using 1.5 T magnetic resonance imaging. DTT demonstrated that the CST of the affected hemisphere was preserved in the medial portion of the hematoma in patient 1, but was interrupted by a hematoma in patient 2. DTT seems to be useful for elucidating the status of the CST in hemiparetic stroke patients. (J Korean Acad Rehab Med 2008; 32: 222-225)
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Original Articles
Hand Function and Diffusion Tensor Imaging according to Response of Evoked Potentials in Post-stroke Hemiplegic Patients.
Park, Gi Young , Cho, Jang Hyuk , Lee, So Young , Bae, Jung Ho , Sohn, Chul Ho , Sohn, Sung Il
J Korean Acad Rehabil Med 2008;32(2):182-188.
Objective: To investigate the association between evoked potentials and fractional anisotropy (FA) ratio in posterior limb of the internal capsule and hand movement scale (HMS) in post-stroke hemiplegic patients.

Method: Thirty-six post-stroke hemiplegic patients with a lesion in the internal capsule were included in this study. Diffusion tensor imaging (DTI) was performed with a 3.0 tesla MR at about 1 month after stroke. FA ratio was measured in posterior limb of the internal capsule of the patients. Motor evoked potential (MEP) was obtained by magnetic stimulation of the motor cortex and recorded from the abductor pollicis muscle. Somatosensory evoked potential (SSEP) was obtained by electrical stimulation of the median nerve at the wrist and recorded from the somatosensory cortex. Hand movement scale was obtained at about 1 month and 3 months after stroke.

Results: Hand movement scale at about 1 month and 3 months after stroke and FA ratio were reduced significantly in patients who showed no response on MEP. However, no significant differences were observed between the patients who showed SSEP response and those who did not. FA ratio and hand movement scale were highly correlated to each other.

Conclusion: MEP and FA ratio can be helpful in assessing the hand function at about 1 month and 3 months in post-stroke hemiplegic patients. (J Korean Acad Rehab Med 2008; 32: 182-188)

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The Effect of Midodrine on Exercise-induced Hypotension in Cervical Cord Injury Patients.
Jung, Hyun , Seo, Jeong Hwan , Ko, Myoung Hwan , Park, Sung Hee , Sim, Young Joo
J Korean Acad Rehabil Med 2008;32(1):45-50.
Objective: To evaluate the effect of midodrine, an Ձ1 agonist, on symptom and hemodynamic response during standing and arm bicycle ergometer exercise in patients with cervical cord injury. Method: Twelve cervical spinal cord injury patients with orthostatic hypotension symptoms and post-exercise hypo- tension were enrolled. They were positioned on a 90° standing frame for 3 minutes. After 15 minutes of resting on supine position, 5 minutes of arm bicycle ergometer exercise was done. These tests were done without midodrine initially, but, with 5 mg midodrine on the next day. Heart rate, self-perceived presyncope score (PPS), systolic and diastolic blood pressure were measured before, during and after the exercise. Results: With 5 mg midodrine, the decrease of systolic and diastolic blood pressures after 3 minutes' standing was significantly smaller than without midodrine (p<0.05). PPS was also significantly decreased with midodrine on standing frame test. Arm ergometer exercise induced less systolic blood pressure decrease and better PPS on immediate and 5 minutes after exercise with midodrine (p<0.05). The change of diastolic blood pressure and heart rate was not significant after the exercise with midodrine. Conclusion: In cervical spinal cord injury patients with orthostatic and post-exercise hypotension, 5 mg midodrine significantly improved the symptoms and the systolic blood pressures. (J Korean Acad Rehab Med 2008; 32: 45-50)
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Comparison of Exercise Indexes between Knee Extension-Flexion Exercise and Treadmill Exercise.
Jang, Byung Hong , Yoon, Tae Sik , Park, Gi Young , Lee, So Young , Bae, Ha Suk
J Korean Acad Rehabil Med 2007;31(5):541-546.
Objective
To obtain clinical usefulness of knee extension- flexion exercise by comparing the exercise indexes between treadmill exercise and knee extension-flexion exercise and to collect reference of exercise indexes using knee extension-flexion exercise. Method: Sixty four young healthy subjects participated in two modes of exercise. Subjects performed exercise using isokinetic dynamometer in one leg knee extension-flexion exercise and treadmill running using Bruce protocol in treadmill exercise. We recorded oxygen consumption, heart rate during rest and exercise. Results: When comparing exercise indexes using treadmill exercise, we obtained relative exercise indexes using knee extension-flexion exercise, male 15.96%, female 15.77% in work rate, male 48.46%, female 52.53% in peak oxygen consumption, male 73.57%, female 80.82% in peak heart rate, male 65.97%, female 65.20% in oxygen pulse, male 56.07%, female 62.50% in peak tidal volume, male 82.56%, female 82.53% in peak respiratory rate, male 47.79%, female 49.48% in peak minute ventilation. In dynamic variables, we obtained male 266.82%, female 292.98% in ratio increase in oxygen consumption to increase in work rate. Conclusion: Knee extension-flexion exercise showed enough response to evaluate cardiorespiratory function through low work rate. Therefore knee extension-flexion exercise may be used for an exercise tolerance test in patients who cannot perform established exercise tolerance test. (J Korean Acad Rehab Med 2007; 31: 541-546)
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Diagnostic Usefulness of Dermatomal Somatosensory Evoked Potentials by Low Intensity Stimulation in Lumbar Radiculopathy.
Seo, Jeong Hwan , Kim, Ji Yeon , Ko, Myoung Hwan , Eun, Jong Pil
J Korean Acad Rehabil Med 2007;31(3):341-345.
Objective
To investigate diagnostic usefulness of dermatomal somatosensory evoked potentials (DSEP) in the evaluation of lumbar radiculopathy using stimulation intensity lower than conventional stimulation intensity. Method: Fifty-seven patients with low back pain were studied with DSEP and needle electromyography (EMG). The radiculopathy was diagnosed by lumbar MRI or operative findings. The DSEP study was performed with stimulation intensity of 1.0×, 1.5×, 2.5× sensory threshold, respectively. We compared the sensitivity and specificity of DSEP and needle EMG in the evaluation of L5 radiculopathy. Results: Radiological and operative findings revealed unilateral herniated disc and L5 root compression in 38 patients (66.7%). Nineteen patients had no significant L5 root compression. The sensitivity and specificity of abnormality were 68.4% and 78.9% in 1.0× sensory threshold stimulation; 71.1%, 78.9% in 1.5× sensory threshold stimulation; and 44.7%, 84.2% in 2.5× sensory threshold stimulation, respectively. Whereas they were 55.2% and 100% in needle EMG. Conclusion: DSEP using low stimulus intensity showed higher sensitivity in the diagnosis of L5 radilculopathy, and DSEP might provide additional diagnostic usefulness in the evaluation of patients with suspected L5 radiculopathy. (J Korean Acad Rehab Med 2007; 31: 341-345)
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Risk Factors of Orthostatic Hypotension in the Ischemic Stroke Patients.
Jeong, Ho Joong , Kim, Ghi Chan , Eom, Moon Sub , Hong, Jin Young
J Korean Acad Rehabil Med 2007;31(3):305-309.
Objective
To determine risk factors of orthostatic hypotension in ischemic stroke patients. Method: In 98 ischemic stroke patients, blood pressure and heart rate were measured after resting in the supine position for 10 minutes and again after standing for one minute. Presence of orthostatic hypotension was correlated with age, gender, body mass index, laboratory findings, diabetes mellitus, anti-hypertensive use, side of involved hemisphere, smoking and K-MBI (Korean Modified Barthel Index). Results: 30 out of 98 patients had orthostatic hypotension. Those patients with orthostatic hypotension were older in age and had a higher average blood pressure, heart rate and plasma creatinine. On the other hand, body mass index, K-MBI and serum sodium levels were lower in the orthostatic hypotension group. Multivariate analysis revealed that age, body mass index, anti-hypertensive use and smoking were independently associated with orthostatic hypotension. Conclusion: Old age, low BMI, anti-hypertensive use, smoking were risk factors of orthostatic hypotension in the ischemic stroke patients. Patients in the higher risk categories should receive regular monitoring of blood pressure in order to detect orthostatic hypotension and prevent its complications. (J Korean Acad Rehab Med 2007; 31: 305-309)
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